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Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery
Ivonne-Marie Bergés1, Yong-Fang Kuo, Glenn V Ostir
1Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas 77555-0460, USA.
Objective:
To examine gender and ethnic differences in functional status and living setting for patients after hip arthroplasty.
Design:
Retrospective cohort study of 69,793 patients receiving inpatient medical rehabilitation after hip arthroplasty included in the Uniform Data System for Medical Rehabilitation database for the period of 2002-2003. Primary measures included functional status as assessed by the FIM instrument and discharge living setting (home vs. not home). The sample included non-Hispanic white, non-Hispanic black, Hispanic, and Asian patients.
Results:
Multivariate regression models showed the greatest FIM instrument change scores from admission to discharge among non-Hispanic whites (mean [SE]: 23.42 [0.18]) and among women (mean [SE]: 22.79 [0.23]). Asians had the lowest mean change scores (mean [SE]: 22.00 [0.53]). Estimates from multivariate logistic models showed that being of nonwhite ethnicity was associated with higher odds of home discharge (black: OR [CI]: 1.23, CI 95% = 1.07, 1.41; Hispanic: OR [CI]: 1.51, CI 95% = 1.15-1.99). Compared with women, men had higher odds of home discharge (OR [CI]: 1.08, CI 95% = 1.01, 1.17).
Conclusions:
The findings suggest that ethnic and gender disparities exist in postacute care outcomes for persons with hip arthroplasty.