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Abstract
Purpose. Analyse racial disparities in clinical outcomes after stroke in inpatient rehabilitation facilities (IRF).
Methods. Analyses based on data from a multi-center prospective observational cohort study on inpatient stroke rehabilitation in six IRFs from across the United States. Multivariate models examined racial disparities in functional outcomes upon discharge, taking into account patient characteristics and detailed information on processes of care.
Results. In the moderate stroke group (N = 397), functional scores on admission were not significantly different between African-Americans and whites. In the severe stroke group (N = 335), whites showed significantly lower functional scores at admission [Functional Independence Measurement, (FIM)], mean scores, 44 versus 49 for African-Americans, p < 0.001). Multivariate analyses predicting discharge motor FIM score found no significant differences between African-American and white stroke patients (p = 0.2194 and p = 0.3547 in the moderate and severe stroke group, respectively).
Conclusion. Controlling for patient characteristics, therapy intensity and processes of care results in non-significant differences between African-Americans and whites in motor FIM scores upon discharge. The absence of significant differences in recovery while patients were on the rehabilitation unit suggests that racial disparities in long-term functional recovery after stroke are likely to have originated before or after the inpatient rehabilitation stay.
Acknowledgements
This project was based on a study entitled, ‘Black-White Disparities in Stroke Rehabilitation’ led by Drs Gerben DeJong and Susan Horn. Direct financial support was provided from the National Institute for Disability and Rehabilitation Research (project no. H133G050153). The authors wish to acknowledge also the department of Medical Sociology of the Vrije Universiteit Brussel and the National Rehabilitation Hospital for their support in providing the necessary accommodation. The views discussed in this article are those of the authors and do not necessarily represent the views for the supporting organizations. They did not have any role in the design or conduct of the study; collection, management, analysis or interpretation of the data, preparation, review or approval of the manuscript.