Citation

Fat SC, Herrera-Escobar JP, Seshadri AJ, Al Rafai SS, Hashmi ZG, de Jager E, Velmahos C, Kasotakis G, Velmahos G, Salim A, Haider AH, Nehra D. Am. J. Surg. 2019; ePub(ePub): ePub.

Affiliation

Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: dnehra@bwh.harvard.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2019.03.024

PMID

30954233

Abstract

BACKGROUND: Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients.

METHODS: Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Utilization of trauma-related healthcare services was asked. Coarsened exact matching (CEM) was used to match African-American and Caucasian patients. Conditional logistic regression then compared matched patients in terms of post-discharge healthcare utilization.

RESULTS: 182 African-American and 1,117 Caucasian patients were followed. Of these, 141 African-Americans were matched to 628 Caucasians. After CEM, we found that African-American patients were less likely to use rehabilitation services [OR:0.64 (95% CI:0.43-0.95)] and had fewer injury-related outpatient visits [OR:0.59 (95% CI:0.40-0.86)] after discharge.

CONCLUSIONS: This study shows the existence of racial disparities in post-discharge healthcare utilization after trauma for otherwise similarly injured, matched patients.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

Long-term outcomes; Patient-reported; Post-discharge; Racial disparities; Rehabilitation utilization; Trauma