Racial Disparities in Outpatient Physical Therapy Use After Hip Fracture: A Retrospective Cohort Study
The Journal of Orthopaedic and Sports Physical Therapy
|November 27, 2024
Summary
Black Medicare beneficiaries are less likely to use outpatient physical therapy (PT) after hip fractures and receive fewer PT visits compared to White beneficiaries. This disparity persists even after accounting for various demographic and socioeconomic factors.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Services Research
Background:
- Hip fractures are a significant cause of morbidity and mortality in older adults.
- Physical therapy (PT) is crucial for recovery and functional improvement after hip fracture.
- Racial disparities in healthcare access and utilization are a persistent concern in the United States.
Purpose of the Study:
- To investigate potential racial disparities in the utilization of outpatient physical therapy (PT) services among Medicare beneficiaries following a hip fracture.
- To determine if Black beneficiaries are less likely to access PT and receive fewer PT sessions compared to White beneficiaries post-hip fracture.
Main Methods:
- Retrospective cohort study analyzing administrative claims data from 51,781 Medicare beneficiaries diagnosed with a hip fracture.
- Hierarchical logistic regression was used to assess the association between race and PT use within six months post-fracture, adjusting for covariates.
- Poisson regression analyzed the association between race and the number of PT visits received.
Main Results:
- Only 31% of all beneficiaries utilized outpatient PT post-hip fracture, with notable racial disparities.
- Black beneficiaries had significantly lower odds of using PT (adjusted odds ratio [aOR], 0.58) compared to White beneficiaries, even after controlling for demographic, medical, and socioeconomic factors.
- Among PT users, Black beneficiaries received fewer PT sessions (adjusted rate ratio [RR], 0.88) compared to White beneficiaries.
Conclusions:
- Significant racial disparities exist in outpatient PT utilization following hip fractures among Medicare beneficiaries.
- Black beneficiaries are less likely to initiate PT and receive fewer PT sessions compared to White beneficiaries, independent of key adjustment factors.
- These findings highlight a critical need to address barriers to PT access and utilization for Black individuals recovering from hip fractures.
