Racial disparities in outcomes of persons with moderate to severe traumatic brain injury

Med Care. 2007 Jul;45(7):686-90. doi: 10.1097/MLR.0b013e31803dcdf3.

Abstract

Background: Although racial differences in hospital outcomes are well known for medical conditions (eg, cardiovascular disease), it is unknown whether differences exist for patients with traumatic brain injury (TBI).

Research design: Using the National Trauma Data Bank, we examined racial and ethnic differences in hospital outcomes of 56,482 patients with moderate to severe TBI who were hospitalized in level I or II trauma-designated hospitals between 2000 and 2003. We examined racial and ethnic disparities in in-hospital mortality and the likelihood of survivors receiving postacute care at a rehabilitation center.

Results: After multivariable adjustment, compared with whites, we observed increased in-hospital mortality for blacks (odds ratio [OR] = 1.19, P = 0.026) and Asians (OR = 1.41, P = 0.005). We observed a trend toward significance for Hispanics (OR = 1.41, P = 0.077), but not for other races. For survivors, compared with whites, blacks and Hispanics were less likely to be discharged to a rehabilitation center (OR = 0.68, P < 0.001, and OR = 0.67, P = 0.002, respectively).

Conclusions: Racial and ethnic disparities exist both in mortality and in discharge to postacute rehabilitation centers among persons with TBI.

MeSH terms

  • Adult
  • Brain Injuries / ethnology*
  • Brain Injuries / mortality
  • Brain Injuries / therapy*
  • Comorbidity
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Hospital Mortality
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Male
  • Rehabilitation Centers / statistics & numerical data
  • Trauma Severity Indices
  • Treatment Outcome