Brooks, Jordan A
(2018)
An examination of Racial disparities in healthcare service utilization and outcomes following traumatic brain injury: a TRACK-TBI pilot study.
Master Essay, University of Pittsburgh.
Abstract
Background: Traumatic brain injury (TBI) is a major public health issue in the United States and is growing in incidence. Racial and ethnic disparities in both health outcomes and healthcare utilization have been documented across a wide range of conditions; however, the data on these disparities in the TBI population remain sparse and equivocal. Disparities in the use of healthcare services may account for observed differences in TBI outcomes.
Methods: This study examined 586 TBI patients who presented to one of three level I US trauma centers between April 2010 and June 2011 and were prospectively enrolled into an observational database. Subjects were longitudinally assessed out to 1 year post-injury. In-hospital and post-hospital healthcare utilization, functional and clinical, and neuropsychological outcomes were collected and assessed for differences between minorities and whites. Univariate and step-wise multivariate analyses were used on each outcome. Multivariate analyses were adjusted for patients’ demographical, clinical, past medical history, and socioeconomic factors.
Results: Overall, there were no observed differences between minorities and whites in in-hospital or post-hospital healthcare utilization, or functional outcomes after controlling for known confounders. Clinically, minorities experienced a significantly higher symptom burden at both three months and six months post injury compared to whites. Minorities also demonstrated increased levels of psychological distress and depression and a decreased satisfaction with life scores compared to whites at the six months following injury.
Conclusion: Though healthcare utilization rates were similar, patients from minority groups had an increased TBI-related symptomatology and psychological distress following TBI compared with whites, even after controlling for known key confounders. Potential disparities in psychological distress and symptom burden in minorities following TBI represent an opportunity for public health interventions.
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| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
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| Status: |
Unpublished |
| Creators/Authors: |
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| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Glynn, Nancy W. | glynn@edc.pitt.edu | UNSPECIFIED | UNSPECIFIED | | Committee Member | Okonkwo, David O. | okonkwodo@upmc.edu | UNSPECIFIED | UNSPECIFIED | | Committee Member | Fabio, Anthony | afabio@pitt.edu | UNSPECIFIED | UNSPECIFIED |
|
| Date: |
26 April 2018 |
| Date Type: |
Completion |
| Number of Pages: |
52 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Date Deposited: |
09 Nov 2018 17:44 |
| Last Modified: |
01 May 2021 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/34246 |
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