# Racial Differences in Hospital-Associated Disability and Acute and Post-Acute Care Physical Therapy Utilization

> **NIH NIH K23** · UNIVERSITY OF CHICAGO · 2024 · $131,760

## Abstract

PROJECT SUMMARY
Hospital-associated disability (HAD), defined as the new loss of ability to complete one or more activities of daily
living without assistance at hospital discharge, occurs in nearly one-third of all hospitalized patients. HAD and
low mobility during hospitalization are associated with readmissions, permanent disability, new
institutionalization, death and escalating healthcare costs. While access to physical therapy (PT) is critical for
functional improvement, my preliminary data from a single site suggests Black patients face disparities in both
functional impairments and PT referrals. However, it is currently unclear whether this is true across sites, whether
social vulnerability affects these outcomes, or why this occurs. Therefore, this proposal aims to characterize the
association of Black race and social vulnerability with development of HAD and referral for acute and post-acute
physical therapy across a set of Chicago area academic medical centers. I also aim to explore racial differences
in perspectives on mobility loss and participation in PT. I hypothesize that Black race and social vulnerability are
associated with HAD and physical rehabilitation use. I will test my hypothesis in three aims: Aim 1) I will assess
differences, by race and Area Deprivation Index (ADI), a measure of social vulnerability, in HAD and inpatient
physical therapy referrals in three academic medical centers across Chicago conferring a socioeconomically
diverse patient sample; Aim 2) Across these medical centers, I will also determine differences by race and ADI,
in rates of recommendation for discharge to post-acute care (PAC) facilties for PT and actual discharge to PAC
facilities for PT when recommended; Aim 3) I will use qualitative methods to explore patients’ experiences with
mobility loss and participation in PT during hospitalization; and interdisciplinary care team documentation for
Black vs. White patients. My long-term goal is to develop a model to predict HAD risk and likelihood of benefit
from skilled physical rehabilitation during hospitalization to reduce the burden of HAD on diverse populations of
patients. To accomplish this, I have developed an exceptional interdisciplinary team of mentors (Drs. Meltzer,
Arora, Lagu) and advisors (Drs. Peek, Chin, Jayaraman, Gibbons) who have a track record of NIH-funding and
successful mentorship of early career investigators. I have formulated an in-depth career development plan to
gain expertise in health disparities research (Chin, Peek, Meltzer), disability and physical rehabilitation in
hospitalized patients, (Arora, Lagu, and Jayaraman), and incorporation of race and social determinants in
statistical modeling to reduce bias (Gibbons, Peek, Chin). Completion of this proposal will train me to address
each level of influence (individual, interpersonal, community, societal) within the “healthcare system” domain of
influence outlined in the NIMHD’s research framework. Equipped with advanced s...

## Key facts

- **NIH application ID:** 10934489
- **Project number:** 5K23MD019072-02
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Maylyn Martinez
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $131,760
- **Award type:** 5
- **Project period:** 2023-09-24 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934489

## Citation

> US National Institutes of Health, RePORTER application 10934489, Racial Differences in Hospital-Associated Disability and Acute and Post-Acute Care Physical Therapy Utilization (5K23MD019072-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10934489. Licensed CC0.

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