Cecil G. Sheps Center for HealthServices Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., Chapel Hill, NC 27599-7590, USA.
Arch Phys Med Rehabil. 2011 Aug;92(8):1220-9. doi: 10.1016/j.apmr.2011.03.019.
To determine the extent to which sociodemographic and geographic disparities exist in the use of postacute rehabilitation care (PARC) after stroke.
Cross-sectional analysis of data for 2 years (2005-2006) from the State Inpatient Databases.
All short-term acute-care hospitals in 4 demographically and geographically diverse states.
Individuals (age, ≥45y; mean age, 72.6y) with a primary diagnosis of stroke who survived their inpatient stay (N=187,188). The sample was 52.4% women, 79.5% white, 11.4% black, and 9.1% Hispanic.
Not applicable.
(1) Discharge to an institution versus home. (2) For those discharged to home, receipt of home health (HH) versus no HH care. (3) For those discharged to an institution, receipt of inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) care. Multilevel logistic regression analyses were conducted to identify sociodemographic and geographic disparities in PARC use, controlling for illness severity/comorbid conditions, hospital characteristics, and PARC supply.
Blacks, women, older individuals, and those with lower incomes were more likely to receive institutional care; Hispanics and the uninsured were less likely. Racial minorities, women, older individuals, and those with lower incomes were more likely to receive HH care; uninsured individuals were less likely. Blacks, women, older individuals, the uninsured, and those with lower incomes were more likely to receive SNF versus IRF care. PARC use varied significantly by hospital and geographic location.
Several sociodemographic and geographic disparities in PARC use were identified.
确定在卒中后接受急性后期康复治疗（PARC）方面存在多大程度的社会人口学和地理差异。
对来自 4 个人口统计学和地理上多样化的州的 2 年（2005-2006 年）州内住院数据库数据进行横断面分析。
所有短期急性护理医院。
符合以下标准的个体（年龄≥45 岁；平均年龄 72.6 岁），有原发性卒中诊断且存活其住院期（N=187188）。样本中，女性占 52.4%，白人占 79.5%，黑人占 11.4%，西班牙裔占 9.1%。
不适用。
（1）出院至机构与出院回家。（2）对于出院回家的患者，接受家庭健康（HH）与不接受 HH 护理的情况。（3）对于出院至机构的患者，接受住院康复机构（IRF）或熟练护理机构（SNF）护理的情况。进行多水平逻辑回归分析，以确定 PARC 使用方面的社会人口学和地理差异，同时控制疾病严重程度/合并症、医院特征和 PARC 供应情况。
黑人、女性、年龄较大的患者以及收入较低的患者更有可能接受机构护理；西班牙裔和未参保者则不太可能。少数民族、女性、年龄较大的患者以及收入较低的患者更有可能接受 HH 护理；未参保者则不太可能。黑人、女性、年龄较大的患者、未参保者以及收入较低的患者更有可能接受 SNF 而非 IRF 护理。PARC 的使用在医院和地理位置上存在显著差异。
确定了 PARC 使用方面的几个社会人口学和地理差异。
