Racial and ethnic differences in postacute rehabilitation outcomes after stroke in the United States

Background and Purpose-Incidence, prevalence, and mortality for stroke vary by race and ethnicity with higher rates for blacks compared with non-Hispanic whites. Little information is available regarding differences in postacute care outcomes for racial and ethnic groups after a stroke. Methods-A retrospective analysis was conducted of 161 692 patients from the Uniform Data System for Medical Rehabilitation who received inpatient medical rehabilitation after a first stroke in 2002 and 2003. Multivariable models examined the effects of race and ethnicity on length of stay, functional status, rehabilitation efficiency, and discharge setting. Results-The mean age was 70.97 years (SD = 12.87), 53% were female, and 76% were non-Hispanic white. Mean length of stay was similar for all groups ranging from 17.39 days (SD = 10.86) to 17.93 (SD = 10.59). Non-Hispanic white patients had higher admission and discharge functional status ratings compared with patients in the minority groups (P < 0.01). Differences in functional status across racial/ethnic groups were related to age (F = 20.49, P < 0.001); the older the comparison group, the greater the difference in functional status. Non-Hispanic whites were discharged home less often than blacks (OR = 0.64, 95% CI = 0.62 to 0.66), Hispanics (OR = 0.58, 95% CI = 0.55 to 0.62), or other minority groups (OR = 0.67, 95% CI = 0.57 to 0.67). Conclusions-The findings suggest racial and ethnic disparities exist in postacute care outcomes for persons with stroke.