THU0707 Race & rehabilitation destination after total hip replacement

Abstract

Background There are marked racial/ethnic disparities in the utilization of hip joint replacement in the US. Differences in post-surgical rehabilitation care may influence this disparity. There is relatively little research on racial variations in post-hip joint replacement surgery care processes. Objectives The main objective of this analysis was to examine racial differences in where patients go for post-acute care rehabilitation after elective hip replacement surgery. We also assessed whether or not where patients go for post-surgery rehabilitation care impacts quality of care markers such as 90-day hospital readmission. Methods A retrospective, large regional dataset analysis using the Pennsylvania Health Care Cost Containment Council database was performed. Patients who underwent elective hip replacement surgery and discharged from Pennsylvania hospitals between fiscal years 2008–2012 were selected. Post-surgery rehabilitation destinations options included: home with self-care, home with home health (HH) care; skilled nursing facility (SNF) and in-patient rehab facility (IRF). We used multinomial logistic regression models to estimate unadjusted and adjusted relative risk ratios (aRRRs) of being discharged home with HH care, to a SNF or to an IRF (vs. home with self-care) after surgery, comparing African-American (AA) to white patients. Multivariable models adjusted for patient-level and facility-level variables associated (p Results Among all patients analyzed, 4,391 self-identified as AA and 63,625 self-identified as white. Among those The Figure summarizes the unadjusted (UN) and adjusted (ADJ) RRRs of referral to an IRF, SNF and HH care (vs. home self-care) in AAs (vs. whites) by age group. Among patients Conclusions Compared to whites, AA patients who underwent hip replacement were more likely to be discharged to an IRF or SNF. Furthermore, discharge to either IRF or SNF was associated with higher risk of hospital readmission. Disclosure of Interest None declared