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Racial Disparities in Outpatient Physical Therapy Use After Hip Fracture: A Retrospective Cohort Study | Journal of Orthopaedic & Sports Physical Therapy
INTRODUCTION: The objective of our study was to examine whether there is a racial disparity among Medicare beneficiaries in the likelihood of using outpatient PT services following a hip fracture. METHODS: Our retrospective descriptive cohort study analyzed administrative claims data for 51,781 Medicare beneficiaries post-hip fracture. We examined the association between race and physical therapy (PT) use within the first 6 months post-fracture using hierarchical logistic regression, adjusting for demographics, medical complexity, and socioeconomic factors. We used Poisson regression to examine the association between race and the number of PT visits. RESULTS: Only 31% of beneficiaries used outpatient PT after hip fracture with significant racial disparities. After controlling for demographics, medical complexity, and socioeconomic factors, Black beneficiaries had 42% lower odds of using PT [aOR = 0.58, 95% CI 0.51-0.66] compared to White beneficiaries. Among PT users, Black beneficiaries received fewer visits than White beneficiaries (RR = 0.85, 95% CI 0.82-0.88) with this disparity persisting after adjustments (RR = 0.88, 95% CI 0.85-0.91). CONCLUSION: Even after adjusting for demographic, medical, and socioeconomic factors, Black beneficiaries were less likely to use outpatient PT following hip fractures. Conditional on an initial PT evaluation, Black beneficiaries received fewer sessions.
