Racial & Ses Differences In Use Of Outpatient Rehabilitation Services For Musculoskeletal Conditions In Kaiser Permanente Southern California Members

PURPOSE: Rehabilitation services are vital to improve patients’ musculoskeletal (MSK) function and strength. Yet, significant health disparities exist in access to outpatient physical therapy (OPT). This study examines racial and socioeconomic (SES) differences in use of OPT for MSK conditions among Kaiser Permanente Southern California (KPSC) members. METHODS: This is a retrospective cross-sectional study between January 1, 2019 through December 31, 2019. KPSC members between 18-65 years old were included with at least 1 MSK condition and 1 OPT encounter. Chi-square test was used to compare OPT encounters for MSK conditions with population characteristics. We used logistic regression analysis to explore the relationship between 1) number of OPT sessions and race and 2) number of OPT sessions and quartiles of income as a measure of SES. RESULTS: We analyzed 2000 eligible patients. Mean age was 47 years old of whom 54% were female participants. Patients were 36% Hispanic, 35% White, 19% Asian and 6% Black. When examining race, odds of having 2 or 3 OPT sessions than 1 OPT session were decreased by 43% for Asian patients compared to White patients. In addition, compared to White patients, odds of having greater than 4 OPT sessions than 1 OPT session were decreased by 47% for Hispanic patients. When examining income, the odds of having greater than 4 OPT sessions than 1 OPT sessions were decreased by 32% for patients in lower 25% income quartile compared to top 25% income quartile. CONCLUSIONS: We found that Hispanic and Asian KPSC members were less likely to attend higher number of OPT sessions for MSK conditions compared to White patients. Furthermore, KPSC patients with lower income quartiles were less likely to have a higher number of OPT visits. Our study shows that racial and SES differences exist in access to OPT services for MSK conditions. Identification of health disparities in OPT services is crucial to develop effective strategies that address unmet needs of KPSC patients.