The impact of race on discharge disposition in patients with hip fracture.

摘要

Background: Hip fracture is a serious injury that is responsible for approximately 300,000 hospital admissions in the US each year, and can require rehabilitation services following hospital discharge. Given the increasing evidence of racial disparity in trauma care interventions, a large dataset was examined for evidence of differential discharge disposition based on race following a diagnosis of hip fracture.;Methods: Participants were identified from the National Trauma Data Bank (NTDB), a voluntary trauma registry maintained by the American College of Surgeons that contains records from over 900 US trauma centers. A diagnosis of hip fracture was selected using ICD-9 codes. Bivarate analyses were performed to test for association between race and several potential covariates. Unadjusted and adjusted logistic regression models were used to test the impact of race on discharge to home vs. home health and home vs. rehab.;Results: There were 36,615 subjects with hip fracture aged 65 and older included in the analysis; 95.8% of were white and 69.3% were female. Race was significantly associated with discharge disposition in a bivariate analysis (p = 0.023). Race did not significantly predict a disposition to home vs. home health in either an unadjusted (OR 1.19, 95% CI 0.85 -- 1.69) or adjusted (OR 1.20, 95% CI 0.84 -- 1.73) analysis. Blacks had a 1.26 higher unadjusted odds of being discharged home vs. rehab (95% CI 1.07 -- 1.49), and a 1.23 higher odds (95% CI 1.02 -- 1.48) after controlling for sex, age, payer source, fracture type, injury severity, and any significant interaction between race and one of the covariates.;Conclusions: Blacks are more likely than whites to be discharged home rather than to rehab following hospital admission for hip fracture.