Ethnic Differences in Discharge Destination Among Older Patients With Traumatic Brain Injury

Chang P-F, Ostir GV, Kuo Y-F, Granger CV, Ottenbacher KJ. Ethnic differences in discharge destination among older patients with traumatic brain injury. Objective: To estimate the association between ethnicity and discharge destination in older patients with traumatic brain injury (TBI). Design: A retrospective analysis. Setting: Nationally representative sample of older patients from the Uniform Data System for Medical Rehabilitation in 2002 and 2003. Participants: Patients (N=9240) aged 65 years or older who received inpatient rehabilitation services for TBI. Interventions: Not applicable. Main Outcome Measures: Discharge destination (home, assisted living facility, institution) and ethnicity (white, black, Hispanic). Results: Multinomial logit models showed that older Hispanics (odds ratio [OR]=2.24; 95% confidence interval [CI], 1.66-3.02) and older blacks (OR=2; 95% CI, 1.55-2.59) with TBI were significantly more likely to be discharged home than older whites with TBI, after adjusting for relevant risk factors. Older blacks were also 78% less likely (OR=.22; 95% CI, .08-.60) to be discharged to an assisted living facility than whites after adjusting for relevant risk factors. Conclusions: Our findings indicate that older minority patients with TBI were significantly more likely to be discharged home than white patients with TBI. Studies are needed to investigate underlying factors associated with this ethnic difference.