Racial disparities in post-discharge healthcare utilization after trauma

Authors

Shelby Chun Fat, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
Juan P. Herrera-Escobar, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
Anupamaa J. Seshadri, Harvard Medical School, Boston, MA, USA
Syeda S. Al Rafai, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
Zain G. Hashmi, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
Elzerie de Jager, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
Constantine Velmahos, Harvard Medical School, Boston, MA, USA
George Kasotakis, Boston University School of Medicine, Boston, MA, USA
George Velmahos, Harvard Medical School, Boston, MA, USA
Ali Salim, Harvard Medical School, Boston, MA, USA
Adil H. Haider, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USAFollow

Document Type

Article

Department

General Surgery

Abstract

Background: Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients.
Methods: Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Utilization of trauma-related healthcare services was asked. Coarsened exact matching (CEM) was used to match African-American and Caucasian patients. Conditional logistic regression then compared matched patients in terms of post-discharge healthcare utilization.
Results: 182 African-American and 1,117 Caucasian patients were followed. Of these, 141 African-Americans were matched to 628 Caucasians. After CEM, we found that African-American patients were less likely to use rehabilitation services [OR:0.64 (95% CI:0.43-0.95)] and had fewer injury-related outpatient visits [OR:0.59 (95% CI:0.40-0.86)] after discharge.
Conclusions: This study shows the existence of racial disparities in post-discharge healthcare utilization after trauma for otherwise similarly injured, matched patients

Publication (Name of Journal)

American journal of surgery

Recommended Citation

Fat, S. C., Herrera-Escobar, J. P., Seshadri, A. J., Rafai, S. S., Hashmi, Z. G., Jager, E. d., Velmahos, C., Kasotakis, G., Velmahos, G., Salim, A., Haider, A. H. (2019). Racial disparities in post-discharge healthcare utilization after trauma. American journal of surgery, 18(5), 842-846.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_gen/260