Abstract TP101: Disposition Disparities: Differences in Discharge and Rehabilitation Post-Stroke Between Racial and Ethnic Groups

Abstract

Background and Purpose: Racial and ethnic disparities affect stroke treatment, altering patient outcomes. Previous studies have shown that white patients often arrive at the Emergency Department more quickly and use Emergency Medical Services more than minority patients. They also receive specific treatments more frequently, including tPA. Our study investigates whether these disparities continue in post-stroke care in Florida. Methods: We conducted a retrospective review using our comprehensive Get with the Guidelines database. We categorized patients by stroke type, risk factors, and stroke severity. The focus was comparing discharge dispositions and rehabilitation plans across racial and ethnic groups. Results: Data gathered from Get with the Guidelines database, including 6,426 records between 2012-present. Discharge disposition disparities were observed across racial and ethnic groups with comparable stroke severity (p<0.001). Black people were more frequently discharged home compared to White people (p=0.029), and Asian people more often went to hospice, especially inpatient (p<0.001). Asian people and White people had the highest in-hospital death rates (p<0.001), while Hispanic people had lower in-hospital deaths(p=0.26) and were more likely discharged home (p=0.001). Black people received the greatest in-patient rehabilitation services (p<0.001), whereas Asian people were least likely to get in-patient or outpatient rehabilitation (p=0.016). Hispanic people had higher inpatient rehabilitation rates than non-Hispanic people (p=0.007). Conclusions: Our study highlights post-stroke disparities across racial and ethnic groups. Recognizing and addressing these disparities may improve outcomes in these populations, increasing stroke management equity. Elucidating the causes of these findings is the next step in this research.