PMID- 34773442
OWN - NLM
STAT- MEDLINE
DCOM- 20221220
LR  - 20221230
IS  - 1934-1563 (Electronic)
IS  - 1934-1482 (Linking)
VI  - 14
IP  - 12
DP  - 2022 Dec
TI  - Centering race/ethnicity: Differences in traumatic brain injury inpatient 
      rehabilitation outcomes.
PG  - 1430-1438
LID - 10.1002/pmrj.12737 [doi]
AB  - BACKGROUND: Persons of color have a higher incidence of traumatic brain injury 
      (TBI) and experience disparities in the quality and quantity of interventions 
      received, discharge disposition, functional outcomes, and mortality rate post 
      TBI. OBJECTIVE: To examine racial/ethnic differences in rehabilitation outcomes 
      for patients with TBI. DESIGN: Multiyear (2005-2016) and retrospective cohort 
      using secondary data analysis from inpatient rehabilitation facilities (IRFs) 
      across the United States. SETTING: eRehabData participating IRFs throughout the 
      United States. PATIENTS: Forty-one thousand eight hundred forty-seven adults with 
      a diagnosis of TBI, admitted to U.S. eRehabData participating IRFs. 
      INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Inpatient rehabilitation 
      functional outcomes and discharge disposition. RESULTS: Participants were 41,847 
      non-Hispanic Whites (NHWs), Hispanics, non-Hispanic Asians (NHAs), and 
      non-Hispanic Blacks (NHBs) aged 18-107 years. NHWs were used as the reference 
      group. NHBs had the longest length of stay (17.65 +/- 14.96). At admission, NHB, 
      Hispanic, and NHA races/ethnicities were significantly associated with 1-3 point 
      lower motor, cognitive, and total Functional Independence Measure (FIM) scores. 
      NHB race was significantly associated with less than 1-point lower cognitive, 
      motor, and total efficiency FIM scores. At discharge, NHB race was significantly 
      associated with 1-2 point lower motor, cognitive, and total FIM scores; Hispanics 
      and NHA race were associated with less than 1-point lower cognitive FIM scores. 
      Compared to NHWs, Hispanic ethnicity was associated with greater odds of a 
      discharge to home (odds ratio = 1.16, 95% confidence interval = 1.06-1.27). 
      CONCLUSION: Contrary to established literature on functionality differences 1 
      year post TBI, the current study found racial/ethnic differences in functional 
      outcomes during inpatient rehabilitation. These findings suggest a need for 
      cultural competence/sensitivity in the care of racial/ethnic persons and 
      centering potential contributing factors for racial/ethnic differences in TBI 
      rehabilitation outcomes.
CI  - (c) 2021 American Academy of Physical Medicine and Rehabilitation.
FAU - Warren, Karlita L
AU  - Warren KL
AUID- ORCID: 0000-0001-6350-6189
AD  - School of Medicine, Keck Graduate Institute, Claremont, California, USA.
FAU - Garcia, James J
AU  - Garcia JJ
AUID- ORCID: 0000-0002-5028-3200
AD  - Department of Psychology, College of Health & Community Well-Being, University of 
      La Verne, La Verne, California, USA.
AD  - Department of Neuropsychology and Psychology, Casa Colina Hospital and Centers 
      for Healthcare, Pomona, California, USA.
LA  - eng
PT  - Journal Article
DEP - 20220105
PL  - United States
TA  - PM R
JT  - PM & R : the journal of injury, function, and rehabilitation
JID - 101491319
SB  - IM
MH  - Adult
MH  - Humans
MH  - United States/epidemiology
MH  - *Ethnicity
MH  - Inpatients
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Brain Injuries, Traumatic
MH  - Rehabilitation Centers
MH  - Length of Stay
MH  - Recovery of Function
EDAT- 2021/11/14 06:00
MHDA- 2022/12/21 06:00
CRDT- 2021/11/13 08:36
PHST- 2021/08/21 00:00 [revised]
PHST- 2021/02/19 00:00 [received]
PHST- 2021/11/06 00:00 [accepted]
PHST- 2021/11/14 06:00 [pubmed]
PHST- 2022/12/21 06:00 [medline]
PHST- 2021/11/13 08:36 [entrez]
AID - 10.1002/pmrj.12737 [doi]
PST - ppublish
SO  - PM R. 2022 Dec;14(12):1430-1438. doi: 10.1002/pmrj.12737. Epub 2022 Jan 5.