Racial disparities in post-discharge healthcare utilization after trauma

Shelby Chun Fat, Juan P. Herrera-Escobar, Anupamaa J. Seshadri, Syeda S. Al Rafai, Zain G. Hashmi, Elzerie de Jager, Constantine Velmahos, George Kasotakis, George Velmahos, Ali Salim, Adil H. Haider, Deepika Nehra

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)


Background: Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients. Methods: Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Utilization of trauma-related healthcare services was asked. Coarsened exact matching (CEM) was used to match African-American and Caucasian patients. Conditional logistic regression then compared matched patients in terms of post-discharge healthcare utilization. Results: 182 African-American and 1,117 Caucasian patients were followed. Of these, 141 African-Americans were matched to 628 Caucasians. After CEM, we found that African-American patients were less likely to use rehabilitation services [OR:0.64 (95% CI:0.43–0.95)] and had fewer injury-related outpatient visits [OR:0.59 (95% CI:0.40–0.86)] after discharge. Conclusions: This study shows the existence of racial disparities in post-discharge healthcare utilization after trauma for otherwise similarly injured, matched patients.

Original languageEnglish
Pages (from-to)842-846
Number of pages5
JournalAmerican Journal of Surgery
Issue number5
Publication statusPublished - Nov 2019
Externally publishedYes


  • Long-term outcomes
  • Patient-reported
  • Post-discharge
  • Racial disparities
  • Rehabilitation utilization
  • Trauma


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