Racial and ethnic disparities in discharge planning among trauma patients in the United States

Trauma patients often require post-discharge services, including home health, nursing care, or inpatient rehabilitation, but disparities may exist.

We analyzed the US National Trauma Data Bank (2011-2021). Insured patients that survived to discharge were stratified by race and ethnicity (non-Hispanic White; non-Hispanic Black; Hispanic; non-Hispanic Asian), and propensity score matched based on age, sex, insurance type, Charlson Comorbidity Index, and Injury Severity Score (ISS). An ordered logistic regression was performed on the matched cohorts to estimate the odds ratio of receiving a higher level of discharge services compared to white patients.

We analyzed 7,172,601 patients. Race and ethnicity composition was 72.8 ​% non-Hispanic White, 14.6 ​% non-Hispanic Black, 10.4 ​% Hispanic, and 2.2 ​% non-Hispanic Asian. Compared to White patients, for non-Hispanic Black patients, the odds ratio of a higher level of discharge services was 0.84 (0.84, 0.85); for Hispanic patients, 0.76 (0.75, 0.76); and for non-Hispanic Asian patients, 0.85 (0.84, 0.86).

In a propensity-matched cohort, all analyzed minority groups had lower odds of receiving a higher level of discharge services than White patients.