Research Stimulus Grants in Aging

Disparities in Post-acute Rehabilitation Care

Project Description

The broad long-term objective of this exploratory study is to inform the development of interventions that will improve access to, use of, and quality of post-acute rehabilitation care for underserved populations. State-specific hospital discharge data from four geographically and demographically diverse states will be analyzed to gain a more thorough and current understanding of disparities in the use of post-acute rehabilitation care following hip fracture, joint replacement, and stroke. These three conditions, which primarily affect the older population, are the most common conditions requiring post-acute rehabilitation care. The hospital discharge data will be merged with data from the American Hospital Association Annual Survey database, the Area Resource File, and the U.S. Census to determine both individual and community-level characteristics associated with the use of post-acute rehabilitation care. Specific aims of the project are: 1) to describe the sociodemographic (race, ethnicity, age, gender, socioeconomic status) and geographic disparities (urban/rural, state) in the use of post-acute rehabilitation care; and 2) to determine the extent to which identified sociodemographic and geographic disparities are explained by other observed characteristics.

The multidisciplinary investigative team includes: Dr. Freburger, PT, PhD (Cecil G. Sheps Center for Health Services Research and Division of Physical therapy); Malcolm Cutchin, PhD (Division of Occupational Science, Institute on Aging, Department of Geography), Lloyd Edwards, PhD (Department of Biostatistics, Institute on Aging), and Mark Holmes, PhD (Cecil G. Sheps Center for Health Services Research, North Carolina Institute on Medicine).