Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery

Am J Phys Med Rehabil. 2008 Jul;87(7):567-72. doi: 10.1097/PHM.0b013e31817c143a.

Abstract

Objective: To examine gender and ethnic differences in functional status and living setting for patients after hip arthroplasty.

Design: Retrospective cohort study of 69,793 patients receiving inpatient medical rehabilitation after hip arthroplasty included in the Uniform Data System for Medical Rehabilitation database for the period of 2002-2003. Primary measures included functional status as assessed by the FIM instrument and discharge living setting (home vs. not home). The sample included non-Hispanic white, non-Hispanic black, Hispanic, and Asian patients.

Results: Multivariate regression models showed the greatest FIM instrument change scores from admission to discharge among non-Hispanic whites (mean [SE]: 23.42 [0.18]) and among women (mean [SE]: 22.79 [0.23]). Asians had the lowest mean change scores (mean [SE]: 22.00 [0.53]). Estimates from multivariate logistic models showed that being of nonwhite ethnicity was associated with higher odds of home discharge (black: OR [CI]: 1.23, CI 95% = 1.07, 1.41; Hispanic: OR [CI]: 1.51, CI 95% = 1.15-1.99). Compared with women, men had higher odds of home discharge (OR [CI]: 1.08, CI 95% = 1.01, 1.17).

Conclusions: The findings suggest that ethnic and gender disparities exist in postacute care outcomes for persons with hip arthroplasty.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Black or African American / statistics & numerical data*
  • Female
  • Health Status
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Postoperative Period
  • Rehabilitation Centers
  • Retrospective Studies
  • Sex Factors
  • Texas
  • Treatment Outcome
  • United States / epidemiology
  • White People / statistics & numerical data*