Disparities in Post-Stroke Care Detailed in New Study

Hispanic people and people without private insurance who have experienced a stroke are more likely to be discharged to their home rather than to a health care facility, according to data published in Neurology Clinical Practice. The report provided additional insights into differences in post-stroke care related to race, ethnicity, and insurance coverage.

Researchers examined data from a pool of 1.1 million people who had experienced a stroke, with >1 million hospital admissions related to ischemic stroke. Of this population, 67% were White, 18% were Black, 9.5% were Hispanic, 3% were Asian-American/Pacific Islander, and 0.4% were Native American. Researchers observed whether participants were discharged to a rehabilitation or health care facility, to a home with health care, or to a home without health care. In total, 36% of people were discharged to a facility, 15% to a home with health care, 43% to a home with no services, 3% died, and 1% left the hospital against medical advice.

In terms of results:

• 49% of Hispanic people and 42% of White people were discharged to a home without health care.
• Only 29% of Hispanic people were discharged to a facility, whereas 37% of both White and Black people were discharged to a facility.
• People with no insurance were 56% less likely to be discharged to a facility vs home, and 21% less likely to be discharged to a home with health care vs without.
• According to a statement by study author Shumei Man, MD, PhD, Black people were 33% more likely to be discharged to a rehabilitation facility vs home, and 42% more likely to be discharged to a home with health care vs without.
• People from New England were more likely to be discharged to a facility vs home, and a home with health care vs without.

“Unfortunately, decisions about care may be influenced by factors such as race, insurance, and geographic location." said Dr. Man of the Cleveland Clinic in Ohio. “Our study found a distinct pattern of disparities in care after stroke in the United States for uninsured people, especially for uninsured Hispanic people, who had the lowest chance of receiving additional care after a stroke.”