Introduction:
Mexican Americans (MAs) have higher stroke incidence compared with non-Hispanic whites (NHWs). Differential use of rehabilitation services could impact stroke outcome. This study was performed to compare the utilization of rehabilitation between MA and NHW in the acute stroke hospital setting.
Hypothesis:
MAs have less access to rehabilitation services during acute stroke hospitalization.
Methods:
Data were obtained from the BASIC (Brain Attack Surveillance in Corpus Christi) Project, a population-based study in Texas. All first strokes identified between July 2009 and June 2011 in patients over the age of 44 were included. Rehabilitation services were abstracted from medical records using the Joint Commission’s definitions. Primary outcome measures were whether the patient was 1) assessed , 2) recommended , and 3) received rehabilitation during the acute hospital stay. Receipt of physical therapy (PT), occupational therapy (OT) and speech pathology (SP) were also specified. Rehabilitation services were compared by ethnicity using Fisher’s Exact tests and/or random effects logistic regression to account for hospital specific effects.
Results:
390 validated strokes met inclusion criteria, 63% were MA. There were no ethnic differences in the rehabilitation services (Table 1). Among those who received rehabilitation services, MAs were more likely to receive OT than NHWs in unadjusted analysis (1.87 [C.I. 1.18-2.94]); however, this association was not apparent after accounting for the hospital in which care was received.
Conclusions:
Encouragingly, availability and receipt of inpatient rehabilitation services after stroke in this community is high and no ethnic differences in access are present. While rehabilitation services during acute stroke hospitalization does not appear to explain ethnic differences in stroke outcome, future work should examine post-discharge rehabilitation services.
Implementation of Acute Stroke Rehabilitation Services in Our Hospital －Comparison Between the Years 2010 and 2000－
