Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery

Objective: To examine gender and ethnic differences in functional status and living setting for patients after hip arthroplasty. Design: Retrospective cohort study of 69,793 patients receiving inpatient medical rehabilitation after hip arthroplasty included in the Uniform Data System for Medical Rehabilitation database for the period of 2002-2003. Primary measures included functional status as assessed by the FIM instrument and discharge living setting (home vs. not home). The sample included non-Hispanic white, non-Hispanic black, Hispanic, and Asian patients. Results: Multivariate regression models showed the greatest FIM instrument change scores from admission to discharge among non-Hispanic whites (mean [SE]: 23.42 [0.18]) and among women (mean [SE]: 22.79 [0.23]). Asians had the lowest mean change scores (mean [SE]: 22.00 [0.53]). Estimates from multivariate logistic models showed that being of nonwhite ethnicity was associated with higher odds of home discharge (black: OR [Cl]: 1.23, Cl-95% = 1.07, 1.41; Hispanic: OR [Cl]: 1-51, Cl-95% = 1.15-1.99). Compared with women, men had higher odds of home discharge (OR [Cl]: 1.08, Cl-95% = 1.0 1, 1.17). Conclusions: The findings suggest that ethnic and gender disparities exist in postacute care outcomes for persons with hip arthroplasty.