Academic Journal
Ethnic Differences in Postacute Stroke Rehabilitation.
| Τίτλος: | Ethnic Differences in Postacute Stroke Rehabilitation. |
|---|---|
| Συγγραφείς: | Hijazi I; Stroke Program, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI., Malingagio A; Stroke Program, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI., Anderson E; Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor, MI., Kwicklis M; Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor, MI., Lisabeth LD; Stroke Program, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI; Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor, MI., Morgenstern LB; Stroke Program, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI; Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor, MI. Electronic address: lmorgens@umich.edu. |
| Πηγή: | Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2026 Jul; Vol. 107 (7), pp. 1542-1549. Date of Electronic Publication: 2025 Nov 21. |
| Τύπος έκδοσης: | Comparative Study; Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 2985158R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-821X (Electronic) Linking ISSN: 00039993 NLM ISO Abbreviation: Arch Phys Med Rehabil Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : W.B. Saunders |
| Ιατρικοί όροι (MeSH): | Healthcare Disparities*/ethnology , Mexican Americans*/statistics & numerical data , Stroke*/ethnology , Stroke Rehabilitation*/statistics & numerical data , White*/statistics & numerical data, Rehabilitation Centers/statistics & numerical data ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies |
| Περίληψη: | Objective: To investigate ethnic differences in poststroke rehabilitation between Mexican American (MA) and non-Hispanic White (NHW) stroke patients. Design: Prospective cohort study. Setting: Community-based (December 2019 to August 2024). Participants: Of 1453 stroke patients (N=1453), the median age was 66 years, 46% were women, and 66% were MA. Interventions: Not applicable. Main Outcome Measures: Stroke patients or their proxies were contacted every 2 weeks for 90 days after stroke to identify their rehabilitation provider: inpatient rehabilitation facility (IRF), skilled nursing facility, home health agency (HHA), or outpatient rehabilitation. Binomial regression was used to model the association of ethnicity (MA vs NHW) with IRF as the first rehabilitation provider. Sequential modeling and propensity-score adjustment were used to investigate demographic and clinical variables impacting ethnic disparities. Results: Rehabilitation services were received by 974 patients in the 90 days after stroke; 34% of patients received no rehabilitation for the first 2 calls. The most common transitions between the first 2 providers were HHA to home without rehabilitation (14%), IRF to HHA (10%), and IRF to home without rehabilitation (7%). NHW patients had higher IRF usage as the first provider compared with MA patients (NHW vs MA risk difference=7.4%, 95% CI, 0.8-14.0). This difference remained after adjustment for patient and clinical factors (risk difference=6.5%, 95% CI, -0.1 to 13.0) and was attenuated by 74.6% after further adjustment for socioeconomic status (risk difference=1.9%, 95% CI, -5.2 to 9.0). Propensity-score methods implemented in a separate model confirmed a smaller, nonsignificant effect (risk difference=2%, 95% CI, -6 to 9) given observed covariates. Conclusions: MA stroke patients are less likely to receive rehabilitation in an IRF as the first provider after stroke compared with NHW stroke patients. This difference is largely explained by socioeconomic status. (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.) |
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| Grant Information: | R01 NS107463 United States NS NINDS NIH HHS; R37 NS038916 United States NS NINDS NIH HHS |
| Contributed Indexing: | Keywords: Hispanic/Latinx; Mexican American; Outcome; Recovery; Rehabilitation; Stroke |
| Entry Date(s): | Date Created: 20251123 Date Completed: 20260708 Latest Revision: 20260924 |
| Update Code: | 20260924 |
| PubMed Central ID: | PMC13596767 |
| DOI: | 10.1016/j.apmr.2025.11.008 |
| PMID: | 41276209 |
| Βάση Δεδομένων: | MEDLINE |
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