Given that a “larger proportion of blacks than whites experience more severe strokes and have a higher likelihood of a motor deficit sufficient to necessitate therapy, the utilization rate of inpatient rehabilitation services is anticipated to be higher among black patients.” However, several studies have revealed that “fewer black than white stroke patients with a need for rehabilitation are receiving this inpatient service.”

The primary purpose of this study was to examine “racially based patterns of use of inpatient rehabilitation services among the stroke patients” of 297 acute-care hospitals in 30 communities within five states. Timing and amount of services used were compared among black and white Medicare patients. The study is a secondary analysis from a national study of quality of hospital care conducted using a sample of Medicare patients.

There were several noted differences between black and white patient characteristics and experiences. For instance, “a statistically significantly larger proportion of blacks were clinically managed in hospitals that were government-operated (ie, county, state, or federal hospital), large (?400 beds), and urban teaching facilities.” Blacks were also more likely to present with a motor deficit on admission. The finding indicated that a slightly larger percentage of black (66.3%) compared with white (55.8%) stroke patients received inpatient physical and occupational therapy (PT/OT). However, “with adjustments for important indicators for receiving inpatient PT/OT,” there was no racial difference in the use of rehabilitation services or the time to initiation of inpatient rehabilitation services.

According to the authors, the “findings suggest that factors other than the patient’s race are important in explaining the observed racial patterns in use of inpatient rehabilitation services for stroke.” Among these possible other factors are region of hospitalization, onsite availability of technology and personnel, and availability of hospital beds.

There are two noteworthy limitations to the study: (1) “no information regarding racial differences in either the mix of services or the quality of the PT/OT therapy received” was available and (2) no data was collected on the use and quality of outpatient rehabilitation services.