J Orthop Sports Phys Ther. 2024 Dec;54(12):776-782. doi: 10.2519/jospt.2024.12641.
To examine whether there was a racial disparity among Medicare beneficiaries in the likelihood of using outpatient physical therapy (PT) services following a hip fracture. Our retrospective descriptive cohort study analyzed administrative claims data for 51 781 Medicare beneficiaries post hip fracture. We examined the association between race and PT use within the first 6 months post fracture using hierarchical logistic regression, adjusting for demographics, medical complexity, and socioeconomic factors. We used Poisson regression to examine the association between race and the number of PT visits. Only 31% of beneficiaries used outpatient PT after hip fracture with significant racial disparities. After controlling for demographics, medical complexity, and socioeconomic factors, Black beneficiaries had 42% lower odds of using PT (adjusted odds ratio [aOR], 0.58; 95% confidence interval [CI]: 0.51, 0.66) compared to White beneficiaries. Among PT users, Black beneficiaries received fewer visits than White beneficiaries (rate ratio [RR], 0.85; 95% CI: 0.82, 0.88) with this disparity persisting after adjustments (RR, 0.88; 95% CI: 0.85, 0.91). Even after adjusting for demographic, medical, and socioeconomic factors, Black beneficiaries were less likely to use outpatient PT following hip fractures. Conditional on an initial PT evaluation, Black beneficiaries received fewer sessions. .
为了研究医疗保险受益人群在髋部骨折后接受门诊物理治疗（PT）服务的可能性方面是否存在种族差异。我们回顾性描述性队列研究分析了 51781 名髋部骨折后医疗保险受益人的行政索赔数据。我们使用分层逻辑回归在骨折后 6 个月内检查了种族与 PT 使用之间的关联，调整了人口统计学、医疗复杂性和社会经济因素。我们使用泊松回归检查种族与 PT 就诊次数之间的关联。只有 31%的髋部骨折受益患者使用了门诊 PT，存在显著的种族差异。在控制人口统计学、医疗复杂性和社会经济因素后，与白人受益患者相比，黑人受益患者使用 PT 的可能性低 42%（调整后的优势比 [aOR]，0.58；95%置信区间 [CI]：0.51，0.66）。在使用 PT 的患者中，黑人受益患者接受的就诊次数少于白人受益患者（比率比 [RR]，0.85；95%CI：0.82，0.88），这种差异在调整后仍然存在（RR，0.88；95%CI：0.85，0.91）。即使在调整了人口统计学、医疗和社会经济因素后，黑人受益患者髋部骨折后使用门诊 PT 的可能性仍然较低。在初始 PT 评估的条件下，黑人受益患者接受的治疗次数较少。
