274345 Racial disparities in discharge location following hospitalization for traumatic falls among the elderly

Sunday, October 28, 2012

Peter Ruestow, MPH , Department of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, IL
Linda Forst, MD, PhD , School of Public Health, University of Illinois, Chicago, IL
Background/Purpose According to the National Center for Injury Prevention and Control, unintentional falls have remained the primary cause of non-fatal injuries among elderly Americans throughout the first decade of the millennium. The major goal of this study was to assess possible racial disparities in post-hospital care among elderly patients treated for falls in Illinois.

Methods Over 70,000 patients (aged 60 years and over) treated at Level 1-2 trauma centers in Illinois (2000-2009) for falls in the home were identified by external injury codes (E-codes) in the Illinois Trauma Registry. Odds ratios were calculated to identify racial differences in discharge status. Race was also considered in a logistic regression model designed to predict whether a patient is discharged to a long-term care or rehabilitation facility.

Results/Outcomes A higher percentage of white, elderly fall patients were discharged to a long-term care or rehabilitation facility than African American or Hispanic patients (60% vs. 45% and 43%, respectively). The odds of African Americans and Hispanics getting discharged to a long-term care or rehabilitation facility were lower than for whites at varying levels of injury severity and length of stay. The predictive model also suggested a statistically significant racial component.

Conclusions African American and Hispanic patients were less likely than white patients to be transferred to a long term care or rehabilitation facility after treatment for a fall injury. These patients may have worse health outcomes after a traumatic fall due to limited rehabilitation opportunities, warranting follow-up study examining longer term morbidity and mortality.

Learning Areas:
Environmental health sciences
Epidemiology

Learning Objectives:
Discuss underlying reasons for the racial disparities observed in discharge location after hospitalization for a traumatic fall. Formulate an analysis using an existing state database, with a focus on organized design and statistical integrity.

Keywords: Access to Care, Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student at the University of Illinois at Chicago's School of Public Health - Environmental and Occupational Health Sciences (EOHS) division. My focus is on occupational and environmental epidemiology. For the last two years, I have worked closely with Dr. Linda Forst, director of the EOHS division, on issues of injury epidemiology and surveillance. Previously, I worked as a clinical data analyst at Advocate Health Care's central office in Oakbrook, Illinois.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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