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Lauren Rimmel, DPT

Job Title

Clinical Specialist

Academic Rank

Instructor

Department

Physical Medicine and Rehabilitation

Authors

Lauren Rimmel PT, DPT; Kathleen Taglieri-Noble PT, DPT; Joseph Tolland PT, DPT; Rebecca Pham PT, DPT; Nicholas Capobianco PT, DPT; Saloni Doshi PT, DPT; Anshul Kumar Ph.D

Principal Investigator

Lauren Rimmel PT, DPT

Categories

Tags

Racial Inequities in Referral and Participation in Outpatient Physical Therapy

Scientific Abstract

Evidence suggests racial inequities and other socioeconomic factors impact physical therapy (PT) utilization. The purpose of this study was to determine if racial and ethnic inequities exist among those who are referred to outpatient PT and those who complete a PT evaluation, as well as to examine the influence of other demographic factors.

Data were sampled retrospectively from July 2021 to July 2022 from electronic medical records. Data collection included demographic factors of race, ethnicity, zip code, insurance payor, and language. A logistic regression model was used to analyze the relationship between appointment success and demographic factors. Mixed effects logistic regression models analyzed the association between demographic and clinical factors and the two outcomes of interest: scheduling an evaluation and appointment attendance.

When examining combined race and ethnicity, non-Hispanic white and non-Hispanic Asian patients had approximately a 10% higher success rate than non-Hispanic Black/African American, Hispanic Black/African American, and Hispanic Latine patients. When examining race only, successful completion of evaluation was 71.2% for Asian patients and 70.0% for white patients. Only 57.1% of Hispanic/Latine patients and 61.4% of Black/African American patients had successful outcomes. This discrepancy warrants further investigation. Data analysis is ongoing, scheduled to be completed by September 2023.

Lay Abstract

Evidence suggests that racial inequities and other socioeconomic factors impact physical therapy (PT) utilization. However, there is limited literature examining the contributing factors to these inequities. The purpose of this study was to determine if racial and ethnic inequities exist among those who are referred to outpatient PT and those who complete a PT evaluation, as well as to examine the influence of other demographic factors.

Preliminary results demonstrated racial and ethnic differences between those who were referred to PT and those who successfully completed a PT evaluation across all specialties. Notably, across all types of outpatient PT, there is increased likelihood for successful outcome for non-Hispanic white and non-Hispanic Asian patients. Additional data analysis is ongoing, scheduled to be completed by October 2023.

Clinical Implications

Limited literature exists regarding factors contributing to inequity in PT utilization. This study determined race and ethnicity impact access to outpatient PT. The outcomes of this study will direct future interventions to reduce inequity in referral and access to PT.