Utilization means nothing when our incompetent stroke medical 'professionals' have DONE NOTHING TO GET TO 100% RECOVERY!
Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? I need an explanation of your incompetence on stroke research and why you're not solving stroke.
Racial, Ethnic, and Regional Disparities of Post-Acute Service Utilization After Stroke in the United States
Abstract
Background and Objectives
Post-acute
care(NOT RECOVERY!) is critical for patient functional recovery and successful
community transition. This study aimed to understand the current racial,
ethnic, and regional disparities in post-acute service utilization
after stroke.
Methods
This
retrospective cross-sectional study included patients hospitalized for
ischemic stroke and intracerebral hemorrhage in 2017–2018 using the
National Inpatient Sample. Discharge destinations were classified as
follows: (1) facility including inpatient rehabilitation, skilled
nursing facility, and facility hospice; (2) home health care (HHC),
including home health and home hospice; and (3) home without HHC.
Multinomial logistic regression was used to study the odds of discharge
to a facility over home and HHC over home without HHC by race,
ethnicity, insurance, and census division, adjusting for clinical
factors and survey design.
Results
Among
the 1,000,980 weighted ischemic stroke admissions, 66.9% were White,
17.6% Black, 9.5% Hispanic, 3.1% Asian American/Pacific Islander, and
0.4% Native American. Relative to private insurance, uninsured patients
had the lowest adjusted odds of facility over home discharge (0.44; 95%
CI 0.40–0.48) and HHC discharge over home without HHC (0.79; 95% CI
0.71–0.88). Compared with White patients, only Hispanic patients with
Medicare/Medicaid insurance or self-pay had lower odds of facility over
home discharge (adjusted OR 0.80 and 0.75, respectively; 95% CI
0.76–0.84 and 0.63–0.93). Uninsured Hispanic patients also had lower
odds of HHC discharge over home without HHC than White patients (0.74;
95% CI 0.57–0.97). Facility discharge rate was the highest in East North
Central (39.2%) and lowest in Pacific (31.2%). HHC discharge rate was
the highest in New England (20.2%) and lowest in West North Central
(10.3%), which had the highest home without HHC discharge (46.1%).
Compared with New England, other census divisions had lower odds of
facility over any home discharge with Pacific being the lowest (adjusted
OR, 0.66; 95% CI 0.60–0.71) and HHC over home without HHC discharge
with West North Central being the lowest (adjusted OR, 0.33; 95% CI
0.29–0.38). Similar patterns were observed in intracerebral hemorrhage.
Discussion
Significant
insurance-dependent racial and ethnic disparities and regional
variations were evident in post-acute service utilization after stroke.
Targeted efforts are needed to improve post-acute service access for
uninsured patients especially Hispanic patients and people in certain
regions.
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