| Title | Racial/ethnic differences in FIM scores and length of stay for underinsured patients undergoing stroke inpatient rehabilitation. | | Author(s) | Chiou-Tan FY, Keng MJ, Graves DE, Chan KT, Rintala DH | | Institution | Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, and the Center for Trauma Rehabilitation Research, Harris County Hospital District, Houston, Texas 77004, USA. | | Source | Am J Phys Med Rehabil 2006 May; 85(5):415-23. | | MeSH | Activities of Daily Living
Adult
Age Distribution
Aged
Aged, 80 and over
Cerebrovascular Accident
Continental Population Groups
Disability Evaluation
Ethnic Groups
Female
Humans
Length of Stay
Male
Medically Uninsured
Middle Aged
Multivariate Analysis
Recovery of Function
Regression Analysis
Rehabilitation Centers
Retrospective Studies
Sex Distribution
Texas
| | Abstract | OBJECTIVE: To explore racial/ethnic differences in FIM data from admission to discharge in underinsured patients undergoing inpatient stroke rehabilitation.
DESIGN: This is a retrospective analysis of the Uniform Data System for Medical Rehabilitation (UDSMR) database of an inpatient rehabilitation unit of a county hospital in a large urban city. Data included 171 adult patients admitted to the stroke rehabilitation unit between January 2000 and October 2003. Main outcome measures included admission and discharge total FIM score, FIM gain, FIM efficiency, and length of stay (LOS). Data were analyzed using chi analyses, t tests, univariate analysis of variance, binary logistic regression, and hierarchical multiple regression.
RESULTS: Data from 68 Hispanic, 83 black, and 20 white patients were included in the study. Univariate tests revealed that race/ethnicity groups differed significantly on admission FIM score (F=5.38, P<0.005), FIM gain (F=4.35, P<0.014), and FIM efficiency (F=3.42, P<0.035). Post hoc pairwise comparisons revealed that Hispanics had lower admission FIM scores than blacks (58.9 vs. 68.9). However, Hispanics had higher FIM gain scores than blacks (26.8 vs. 21.5). Race/ethnicity was not significantly related to age, gender, side of stroke, type of stroke, time from onset of stroke to rehabilitation admission, discharge FIM score, or LOS. Multiple regression analyses revealed that after controlling for all other available factors, race/ethnicity accounted for a significant amount of additional variance in admission FIM score (5.8%) and FIM efficiency (4.6%), but not in discharge FIM score, FIM gain, or LOS. Race/ethnicity was not predictive of discharge disposition.
CONCLUSIONS: Differences in functional independence at admission to poststroke rehabilitation and the average daily improvement in function are related, in part, to patients' race/ethnicity. Differences in change in functional independence from admission to discharge (FIM gain) are not related to race/ethnicity once other factors, particularly admission FIM score, are taken into account. Future studies should identify reasons why Hispanics have lower admission FIM scores because demographic and stroke-related variables were not related to ethnicity yet have outcomes similar to blacks and whites at discharge. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16628148 |
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