ArticleNeurology. Clinical practice2024
Racial, Ethnic, and Regional Disparities of Post-Acute Service Utilization After Stroke in the United States.
Article in Neurology. Clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Racial and ethnic disparities in endovascular treatment outcomes in acute ischemic stroke: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- Aphasia among Medicare fee for service beneficiaries: initial encounter for services and discharge disposition.Aphasiology · 2026Article
- Managing cyanotic neonates with tetralogy of Fallot: A national perspective on surgical approaches.JTCVS open · 2026Article
- Association of Dual Eligibility and Medicare Type With Quality of Postacute Care After Stroke.JAMA network open · 2026Article
- Incidence and risk factors for post-stroke delirium in the elderly: A national inpatient sample (NIS) analysis.PloS one · 2026Article
- Racial and Rural Disparities in Stroke Discharge Disposition Stratified by 90-Day Survival Status.Journal of the American Medical Directors Association · 2025Article
- Differences in patterns of outpatient epilepsy-specific medication initiation after acute ischemic stroke in the Medicare population.Epilepsia · 2025Observational
- Article
- A novel automated CT biomarker to predict outcomes in acute ischemic stroke: net water uptake.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Objectives: Post-acute care is critical for patient functional recovery and successful community transition. This study aimed to understand the current racial, ethnic, and regional disparities in post-acute service utilization after stroke. Methods: This retrospective cross-sectional study included patients hospitalized for ischemic stroke and intracerebral hemorrhage in 2017-2018 using the National Inpatient Sample. Discharge destinations were classified as follows: (1) facility including inpatient rehabilitation, skilled nursing facility, and facility hospice; (2) home health care (HHC), including home health and home hospice; and (3) home without HHC. Multinomial logistic regression was used to study the odds of discharge to a facility over home and HHC over home without HHC by race, ethnicity, insurance, and census division, adjusting for clinical factors and survey design. Results: Among the 1,000,980 weighted ischemic stroke admissions, 66.9% were White, 17.6% Black, 9.5% Hispanic, 3.1% Asian American/Pacific Islander, and 0.4% Native American. Relative to private insurance, uninsured patients had the lowest adjusted odds of facility over home discharge (0.44; 95% CI 0.40-0.48) and HHC discharge over home without HHC (0.79; 95% CI 0.71-0.88). Compared with White patients, only Hispanic patients with Medicare/Medicaid insurance or self-pay had lower odds of facility over home discharge (adjusted OR 0.80 and 0.75, respectively; 95% CI 0.76-0.84 and 0.63-0.93). Uninsured Hispanic patients also had lower odds of HHC discharge over home without HHC than White patients (0.74; 95% CI 0.57-0.97). Facility discharge rate was the highest in East North Central (39.2%) and lowest in Pacific (31.2%). HHC discharge rate was the highest in New England (20.2%) and lowest in West North Central (10.3%), which had the highest home without HHC discharge (46.1%). Compared with New England, other census divisions had lower odds of facility over any home discharge with Pacific being the lowest (adjusted OR, 0.66; 95% CI 0.60-0.71) and HHC over home without HHC discharge with West North Central being the lowest (adjusted OR, 0.33; 95% CI 0.29-0.38). Similar patterns were observed in intracerebral hemorrhage. Discussion: Significant insurance-dependent racial and ethnic disparities and regional variations were evident in post-acute service utilization after stroke. Targeted efforts are needed to improve post-acute service access for uninsured patients especially Hispanic patients and people in certain regions.
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Registered trials
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