Racial disparities in post-discharge healthcare utilization after trauma.
(Journal Article;Multicenter Study)
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.
Chun Fat, S; 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
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