Race and rehabilitation following spinal cord injury: equality of access for American Indians/ Alaska Natives compared to other racial groups

Injury Epidemiology, 2015 · DOI: 10.1186/s40621-015-0049-0 · Published: June 10, 2015

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This study investigates whether American Indians/Alaska Natives (AIs/ANs) have equal access to rehabilitation services after a spinal cord injury (SCI) compared to other racial and ethnic groups. The researchers used data from the National Trauma Data Bank (NTDB) to compare the rate of discharge to rehabilitation facilities (DRF) among different racial groups after a traumatic SCI. The study found that AIs/ANs access rehabilitative care at a rate equitable to or greater than other races when multiple factors are taken into account.

Study Duration

5 Years

Participants

29,443 patients with spinal cord injuries aged 15 to 64

Evidence Level

Retrospective Analysis

Key Findings

1
AIs/ANs were significantly younger, had a higher probability of death, and had longer hospital stays compared to non-AIs/ANs.
2
AIs/ANs were proportionately more likely to be discharged to rehabilitation compared to non-AIs/ANs.
3
Regression models demonstrated increased odds of discharge to rehabilitation facilities for AIs/ANs compared to Hispanic and Asian racial/ethnic groups.

Research Summary

This study aimed to compare the rate of discharge to rehabilitation facilities (DRF) following traumatic SCI among adult AIs/ANs to other racial/ethnic groups for patients 15 to 64 years old. The results indicated that American Indians/Alaska Natives who sustain SCI access rehabilitative care at a rate equitable to or greater than other races when multiple factors are taken into account. Further research is needed to assess the effect of patient, physician, and health care system determinants on a patient’s ability to access post-trauma rehabilitative care.

Practical Implications

Policy Implications

Findings can inform policymakers and tribal leaders about access to care issues in AI/AN communities, specifically for SCI patients.

Future Research

Further research should investigate patient, physician, and healthcare system factors influencing access to post-trauma rehabilitation.

Healthcare Delivery

Healthcare providers should consider race, comorbidities, and a patient's ability to synthesize medical information when developing treatment plans.

Study Limitations

1
The NTDB is a convenience sample, limiting generalizability.
2
Potential for misclassification of race/ethnicity due to data gathering variations.
3
Exclusion criteria may have biased the results.

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