Centering race/ethnicity: Differences in traumatic brain injury inpatient rehabilitation outcomes.

Introduction Persons of color have a higher incidence of Traumatic Brain Injury (TBI) and experience disparities in the quality and quantity of interventions received, discharge disposition, functional outcomes, and mortality rate post TBI. Objective To examine racial/ethnic differences in rehabilitation outcomes for TBI patients. Design Multi-year (2005-2016) and retrospective cohort using secondary data analysis from Inpatient Rehabilitation Facilities (IRFs) across the Unites States. Setting eRehabData participating IRFs throughout the United States. Patients 41847 adults with a diagnosis of TBI, admitted to U.S. eRehabData participating IRFs. Interventions Not applicable. Main outcome measures Inpatient rehabilitation functional outcomes and discharge disposition. Results Participants were 41 847 non-Hispanic Whites (NHW), Hispanics, non-Hispanic Asians (NHA), and non-Hispanic Blacks (NHB) aged 18-107 years. NHW were used as the reference group. NHB had the longest length of stay (17.65 ± 14.96). At admission, NHB, Hispanic, and NHA race/ethnicities were significantly associated with 1-3 point lower motor, cognitive, and total Functional Independence Measure (FIM) scores. NHB race/ethnicity was significantly associated with less than 1-point lower cognitive, motor, and total efficiency FIMscores. At discharge, NHB race/ethnicity was significantly associated with 1-2 point lower motor, cognitive, and total FIM scores; Hispanics and NHA race/ethnicity were associated with less than 1-point lower cognitive FIM scores. Compared to NHWs, Hispanic race/ethnicity was associated with greater odds of a discharge to home (OR = 1.163, 95% CI = 1.06-1.27). Conclusion Contrary to established literature on functionality differences 1-year post TBI, the current study found racial/ethnic differences in functional outcomes during inpatient rehabilitation. These findings suggest a need for cultural competence/sensitivity in the care of racial/ethnic persons and centering potential contributing factors for racial/ethnic differences in TBI rehabilitation outcomes. This article is protected by copyright. All rights reserved.