Journal
MEDICAL CARE
Volume 45, Issue 7, Pages 686-690Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MLR.0b013e31803dcdf3
Keywords
traumatic brain injury; race; disparity; mortality; rehabilitation
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Background: Although racial differences in hospital outcomes are well known for medical conditions (eg, cardiovascular disease), it is unknown whether differences exist for patients with traumatic brain injury (TBI). Research Design: Using the National Trauma Data Bank, we examined racial and ethnic differences in hospital outcomes of 56,482 patients with moderate to severe TBI who were hospitalized in level I or 11 trauma-designated hospitals between 2000 and 2003. We examined racial and ethnic disparities in in-hospital mortality and the likelihood of survivors receiving postacute care at a rehabilitation center. Results: After multivariable adjustment, compared with whites, we observed increased in-hospital mortality for blacks (odds ratio [OR] = 1.19, P = 0.026) and Asians (OR = 1.41, P = 0.005). We observed a trend toward significance for Hispanics (OR = 1.41, P = 0.077), but not for other races. For survivors, compared with whites, blacks and Hispanics were less likely to be discharged to a rehabilitation center (OR = 0.68, P < 0.001, and OR = 0.67, P = 0.002, respectively). Conclusions: Racial and ethnic disparities exist both in mortality and in discharge to postacute rehabilitation centers among persons with TBI.
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