Gregory Patricia C, Han Euna, Morozova Olga, Kuhlemeier Keith V
Department of Physical Medicine and Rehabilitation, The University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA.
Am J Phys Med Rehabil. 2006 Oct;85(10):814-9. doi: 10.1097/01.phm.0000237870.07136.24.
Black patients tend to have a greater number and severity of stroke cases. The literature on access to rehabilitative services shows mixed results ranging from no disparities to limited access among minority populations. This study evaluated the association of race and acute discharge to inpatient stroke rehabilitation in Maryland, a diagnostic related group-and postacute care prospective payment system-exempt state.
Data from the Maryland Health Services and Cost Review Commission database for 2000 was used to conduct a cross sectional retrospective review to determine the rate of disposition to inpatient rehabilitation facilities (IRF). Multiple logistic regression analyses evaluated factors associated with discharge to IRF in this population.
There were a total of 12,208 patients hospitalized with stroke in the year 2000. Compared with urban-dwelling white patients, black patients who lived in urban dwellings were more likely to be discharged to IRF, OR 1.42, 95% CI (1.06, 1.91).
In the state of Maryland, urban-dwelling black stroke patients were more likely to be discharged to IRF acutely after stroke. Future studies should assess whether this trend persists in states that have larger rural populations.
黑人患者的中风病例数量往往更多，病情也更严重。关于获得康复服务的文献结果不一，从没有差异到少数族裔人群获得的服务有限。本研究评估了种族与马里兰州急性出院后接受住院中风康复治疗之间的关联，马里兰州是一个免于诊断相关组和急性后护理前瞻性支付系统的州。
使用来自2000年马里兰州卫生服务和成本审查委员会数据库的数据进行横断面回顾性研究，以确定住院康复设施（IRF）的处置率。多元逻辑回归分析评估了该人群中与出院至IRF相关的因素。
2000年共有12208名中风住院患者。与居住在城市的白人患者相比，居住在城市的黑人患者更有可能被出院至IRF，比值比为1.42，95%置信区间为（1.06，1.91）。
在马里兰州，居住在城市的黑人中风患者在中风后更有可能被急性出院至IRF。未来的研究应评估这种趋势在农村人口较多的州是否持续存在。
