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Examining Institutional Integrity: Race and Rehabilitation Service Utilization in a Global Pandemic

Eboni A. Reed, MD (University of Michigan, Ann Arbor, Michigan); Alecia K. Daunter, MD

Meeting: AAPM&R Annual Assembly 2021

Categories: Practice Management, Leadership, and Quality Improvement (2021)

Session Information

Session Title: Research Spotlight: Practice Management, Leadership, and Quality Improvement

Session Time: None. Available on demand.

Disclosures: Eboni A. Reed, MD: No financial relationships or conflicts of interest

Objective: Determine whether black patients received equitable rehabilitation care while admitted to a quaternary academic medical center during the initial peak of the global pandemic.

Design: Prospective chart review.Setting : Academic quaternary care hospital.Participants : Three hundred nineteen hospitalized adult patients with a positive test for SARS-CoV-2 between March 4 and May 1 of 2020.

Interventions: Not applicable.

Main Outcome Measures: Demographics including age, sex, and race/ethnicity. Admission length of stay, nights on mechanical ventilation, LACE score at the time of discharge, number of physical, occupational and speech therapy visits completed and discharge location.

Results: The final analysis included 239 participants with an average age of 60.38, length of stay 13.21 nights, and time on mechanical ventilation 3.22 nights. Of those included in the final analysis, 101 identified as white, 105 identified as black and 32 identified as Hispanic non-black, Asian or other. When controlling for age age and length of stay, the average number of therapy sessions, PT/OT/SLP, was 5.746 (±.542, 95% confidence interval [4.678-6.814]) for white patients, 6.289 (±.528, 95% confidence interval [5.248-7.330]) for black patients, and 5.468 (±.954, 95% confidence interval [3.590-7.347]) for others, which includes Hispanic and Asian patients. Similarly when controlling for age and time on mechanical ventilation, the average number of therapy sessions for white, black, and others was 5.913, 6.476, and 3.931 respectively. Sixty-seven white patients (66.3%) were discharged home, 22 (21.8%) discharged to SNF/SAR compared to black patients where 87 (82.1%) were discharged home and thirteen (12.3%) discharged to SNF/SAR.Conclusions: Black survivors of COVID-19 had higher likelihood of functional decline and longer lengths of stay. There was no significant difference amongst the number of therapy visits completed during admission when adjusted for length of stay. However, white patients were nearly twice as likely to be discharged to subacute rehabilitation than black patients.

Level of Evidence: Level II

To cite this abstract in AMA style:

Reed EA, Daunter AK. Examining Institutional Integrity: Race and Rehabilitation Service Utilization in a Global Pandemic [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/examining-institutional-integrity-race-and-rehabilitation-service-utilization-in-a-global-pandemic/. Accessed May 11, 2025.
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