Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery.

Abstract

To examine gender and ethnic differences in functional status and living setting for patients after hip arthroplasty. Retrospective cohort study of 69,793 patients receiving inpatient medical rehabilitation after hip arthroplasty included in the Uniform Data System for Medical Rehabilitation database for the period of 2002-2003. Primary measures included functional status as assessed by the FIM instrument and discharge living setting (home vs. not home). The sample included non-Hispanic white, non-Hispanic black, Hispanic, and Asian patients. Multivariate regression models showed the greatest FIM instrument change scores from admission to discharge among non-Hispanic whites (mean [SE]: 23.42 [0.18]) and among women (mean [SE]: 22.79 [0.23]). Asians had the lowest mean change scores (mean [SE]: 22.00 [0.53]). Estimates from multivariate logistic models showed that being of nonwhite ethnicity was associated with higher odds of home discharge (black: OR [CI]: 1.23, CI 95% = 1.07, 1.41; Hispanic: OR [CI]: 1.51, CI 95% = 1.15-1.99). Compared with women, men had higher odds of home discharge (OR [CI]: 1.08, CI 95% = 1.01, 1.17). The findings suggest that ethnic and gender disparities exist in postacute care outcomes for persons with hip arthroplasty.