Abstract
BACKGROUND: Racial disparities are present in the U.S. medical system and lead to detrimental health outcomes and reduced quality of life for many patients. These can be seen in the increased number of amputations among patients from underrepresented minority groups, in addition to differences in access to appropriate rehabilitation care in many debilitating diagnoses. OBJECTIVE: To examine racial differences in access to rehabilitation consultation and discharge to an inpatient rehabilitation facility (IRF) among patients in an acute care setting following an amputation. METHODS: Retrospective convenience sample at a tertiary care hospital from a limited database. The study included 640 participants ≥18 years of age who had undergone an amputation at an academic hospital between January 2020 and March 2023. Patients <18, pregnant women, prisoners, those who identified as Native Hawaiian due their low number (n = 1), or those who had undergone solely phalangeal amputations were excluded. The primary outcomes of this study were the discharge destination after acute care hospital and acute care length of stay. RESULTS: There was a statistically significant association between age and discharge disposition, with a 2% increase in the likelihood of discharge to IRF for each additional year. The length of stay between different racial and ethnic groups showed statistically significant differences, with Asian patients having the longest (23.3 days) and those identifying as "two or more races" having the shortest (11.9 days) stays. When comparing between White, Black, and Hispanic patients, Black patients had the longest length of stay (19.9 days). Lastly, patients who received physiatry consultation were 20 times more likely to be discharged to IRF. CONCLUSION: Patients from underrepresented minority groups had a longer acute care length of stay. Race and ethnicity did not appear to affect the amputation level or discharge disposition, including discharge to acute inpatient rehabilitation. Age and the presence of physiatric consultation had the greatest impact on determining the discharge disposition of patients with amputations.