SHM Converge Scientific Abstract ePoster Gallery-Physical Restraint Use in Hospitals Across the United States: 2011-2019

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This study examined trends in physical restraint use in U.S. hospitals from 2011 to 2019 using the National Inpatient Sample, focusing on adult inpatients and differences by age, race, insurance, income, and hospital location. Physical restraints are associated with serious harms such as delirium, pressure ulcers, longer ventilator use, and PTSD, and national efforts have aimed to reduce their use.<br /><br />The researchers analyzed more than 304 million hospitalizations and found that restraint use remained persistently high over the study period rather than declining as expected. In 2018–2019, restraint use showed notable disparities. Black patients were more likely than White patients to be restrained (adjusted odds ratio 1.38), and patients with Medicaid were more likely to be restrained than those with private insurance (aOR 2.08). Lower-income patients also had higher odds of restraint use. In addition, restraint use varied significantly by geography, with differences across hospital regions and urban versus rural settings.<br /><br />Patients who were physically restrained were generally older, more likely to be male, and more likely to have greater illness severity. The study also found substantial variation in restraint use by hospital characteristics such as bed size and region.<br /><br />Overall, the authors concluded that despite awareness and guidance to reduce physical restraints, practice has not changed meaningfully at a national level. The observed differences by race, insurance, income, and geography may reflect structural inequities, regional policy differences, hospital culture, and uneven adoption of evidence-based care.

Asset Subtitle

Ishaan Gupta

Meta Tag

Author List Amteshwar Singh, Che Harris, Ilana Nelson-Greenberg, Ishaan Gupta, Scott M. Wright

Category Research

Concept Physical Restraint

Concept Adjusted Odds Ratio

Concept Multivariable Logistic Regression

Concept Hospital

Concept Age

Distinguished Non-Finalist

Presenter Organization Johns Hopkins University School of Medicine

Presenting Author Ishaan Gupta

Track Patient Safety

Keywords

physical restraint

hospitalization

U.S. hospitals

health disparities

race inequity

Medicaid

income inequality

hospital geography

patient safety

National Inpatient Sample

Physical Restraint

Adjusted Odds Ratio

Multivariable Logistic Regression

Hospital

Age