Premium
Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID ‐19 condition
Author(s) -
Hentschel Claudia B.,
Abramoff Benjamin A.,
Dillingham Timothy R.,
Pezzin Liliana E.
Publication year - 2022
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1002/pmrj.12869
Subject(s) - medicine , rehabilitation , incidence (geometry) , ethnic group , physical therapy , weakness , odds ratio , covid-19 , disease , surgery , physics , sociology , anthropology , infectious disease (medical specialty) , optics
Outpatient rehabilitation is recommended in the treatment of post coronavirus disease 2019 (COVID‐19) condition. Although racial and ethnic disparities in the incidence and severity of COVID‐19 have been well documented, little is known about the use of outpatient rehabilitation among patients with post COVID‐19 condition. Objective To examine factors associated with outpatient rehabilitation use following COVID‐19 and to ascertain whether differential incidence of sequelae explain variation in post COVID‐19 rehabilitation utilization by race and ethnicity. Design Case–control study. Setting Community. Participants U.S. adults with COVID‐19 during 2020 in the TriNetX database. Intervention N/A. Main Outcome Measures Receipt of outpatient rehabilitation services within 6 months of COVID‐19 diagnosis and incidence of post COVID‐19 condition symptoms (weakness, fatigue, pain, cognitive impairment, mobility difficulties, and dyspnea). Results From 406,630 laboratory‐confirmed COVID‐19 cases, we identified 8724 individuals who received outpatient rehabilitation and matched 28,719 controls. Of rehabilitation users, 43.3% were 40 years old or younger, 54.8% were female, 58.2% were White, 17.9% were African American/Black, 2.1% were Asian, 13.0% were Hispanic, 39.2% had no comorbidities, and 40.3% had been hospitalized for COVID‐19. Dyspnea (20.4%), fatigue (12.4%), and weakness (8.2%) were the most frequently identified symptoms. Although there were no racial differences in the incidence of the six post COVID‐19 condition symptoms considered, African American/Black individuals were significantly less likely than their White counterparts to receive outpatient rehabilitation (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.84–0.96; p = .003). Hispanic individuals had higher outpatient rehabilitation utilization (OR = 1.22; 95% CI: 1.11–1.33; p < .001) and a significantly higher incidence of post COVID‐19 fatigue. Conclusions In this large nationally representative study, African American/Black race was associated with lower utilization of outpatient rehabilitation services despite a similar incidence of post COVID‐19 condition symptoms. Further research is needed to better understand access barriers to rehabilitation services for post COVID‐19 condition recovery care and address racial inequalities in receipt of care.