Disparities in Access to Outpatient Rehabilitation Therapy for African Americans with Arthritis

Abstract

Background: Approximately, 10 million Americans have an outpatient physical therapy or occupational therapy visit per year. This population is largely Caucasian, insured, educated and middle or high income. Purpose: The purpose of this study was to determine the existence of racial and/or ethnic disparities in patients with self-reported arthritis accessing office-based therapy services in the USA. Method: A pooled analytic file of 2008–2010 data from the Medical Expenditure Panel Survey-Household Survey was created. We first conducted a descriptive analysis of the utilization of therapy services for persons reporting arthritis. From the descriptive analysis, we formulated experimental hypotheses that we tested to determine if a racial disparity existed to access therapy services between White and Asian persons with arthritis and Black/Hispanic populations. To test our hypotheses, we determined the odd ratios using a logistic regression analysis. We conducted a similar analysis controlling for education, income, and insurance status. Results: Eight percent of the US adult population with self-reported arthritis has an office-based therapy visit each year. Hispanic and Black Americans with arthritis have a reduced odds of a therapy visit (26.5 % [95 % CI 7–42 %] and 44.8 % [95 % CI 31.9–55.3 %], respectively). We did not find a similar effect on odds of a therapy visit for the Asian American population. The effect of race/ethnicity on the odds of a therapy visit was moderated by socioeconomic variables but persists for Black Americans. Discussion/Conclusion: The results of this study confirm a reduced likelihood of an office-based therapy visit for Black Americans with arthritis when controlled for income, insurance, and education. An effect of race/ethnicity on the likelihood of a therapy visit for Hispanic Americans with arthritis disappears when controlled for income, insurance, and education.