SHM Converge Scientific Abstract ePoster Gallery-Racial Disparities in Hospital-Associated Disability and Physical Therapy Referral

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This study examined racial disparities in functional impairment, hospital-associated disability (HAD), mobility change, and physical therapy (PT) referral among 20,810 medical inpatients from 2018–2021.

<strong>Background:</strong> About 31% of hospitalized patients develop HAD, which increases risk of readmission, permanent disability, institutionalization, and death. PT can help prevent or treat HAD. Prior research suggests Black patients have worse physical function and mobility outcomes but are referred to rehabilitation less often.

<strong>Methods:</strong> The authors conducted a cross-sectional study of patients admitted to medicine services. They measured:
- Functional impairment using AM-PAC scores
- HAD as admission AM-PAC 18 and discharge AM-PAC 18
- Mobility change as discharge AM-PAC minus admission AM-PAC
- PT referral during hospitalization

They compared outcomes by race using chi-square tests and t-tests, and used regression models to adjust for age, sex, baseline mobility, mobility change, and length of stay.

<strong>Results:</strong> Compared with White patients, Black patients:
- Had more functional impairment on admission
- Showed less mobility gain during hospitalization
- Received slightly fewer PT referrals

In adjusted analyses, Black race remained associated with poorer mobility change and lower PT referral. Among patients with functional impairment, Black patients had lower PT referral rates and less improvement in mobility. The study also found age, baseline mobility, and length of stay were important predictors of mobility change and PT referral.

<strong>Conclusion:</strong> Black hospitalized patients with functional impairment experience worse mobility gains and are referred to PT less often than White patients. The authors suggest clinicians should consider Black race, along with functional impairment, as a risk factor when deciding on PT referral for hospitalized patients.

Asset Subtitle

Maylyn Martinez

Meta Tag

Author List Andrew W. Schram, David O. Meltzer, Mahnoor Baig, Marla Robinson, Matthew T. Cerasale, Maylyn Martinez, Monica Peek, Vineet Arora

Category Research

Concept Race

Concept Hospital-Acquired Disability

Concept Impaired Functioning

Concept Inpatient Physical Therapy Referral

Concept Mobility

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Maylyn Martinez

Track Other

Keywords

racial disparities

functional impairment

hospital-associated disability

mobility change

physical therapy referral

Black patients

medical inpatients

AM-PAC scores

hospitalization outcomes

rehabilitation access

Race

Hospital-Acquired Disability

Impaired Functioning

Inpatient Physical Therapy Referral

Mobility