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General Rehabilitation

Session: Racial and Ethnic Disparities in Rehabilitation Services Utilization for Patients with Intellectual Disability: a TriNetX Study

Racial and Ethnic Disparities in Rehabilitation Services Utilization for Patients with Intellectual Disability: A TriNetX Study

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Original Research Theater

    Poster Presenter(s)

  • Ethan J. Le (he/him/his)

    Medical Student
    Sidney Kimmel Medical College At Thomas Jefferson University
    Philadelphia, Pennsylvania

    • Co-Author(s)

  • Joshua H. Kim

    Medical Student
    Sidney Kimmel Medical College At Thomas Jefferson University
    Philadelphia, Pennsylvania

  • JZ

    Jeffrey Zhou, Other

    Medical Student
    Sidney Kimmel Medical College At Thomas Jefferson University
    Philadelphia, Pennsylvania

  • HF

    Hannah Facey, MD (she/her/hers)

    Assistant Professor of Family and Community Medicine
    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, Pennsylvania

  • Nethra Ankam, MD (she/her/hers)

    Professor of Rehabilitation Medicine
    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, Pennsylvania

Disclosure(s):
Ethan J. Le: No financial relationships to disclose
Joshua H. Kim: No financial relationships to disclose
Jeffrey Zhou, Other: No financial relationships to disclose
Hannah Facey, MD: No financial relationships to disclose
Nethra Ankam, MD: No financial relationships to disclose
Background and/or Objectives: Black and Hispanic patients with intellectual disability (ID) experience poorer health outcomes, reflecting broader healthcare disparities. While disparities in rehabilitation services use among individuals with ID are well documented, concurrent racial and ethnic differences in access remain unclear.

Design: Propensity score matched retrospective cohort analysis.

Setting : Using the TriNetX database, we analyzed the de-identified electronic health record data of over 138 million patients across 109 healthcare organizations.

Participants : Adult patients with ID who identify as either Caucasian (IDC) compared to African American or Latino (IDAAL). Patients were propensity score matched based on age, gender, and select medical comorbidities.

Interventions: Not applicable.

Main Outcome Measures: Pre and post matched cohorts were assessed for utilization rates of Physical Medicine and Rehabilitation (PM&R) services, Physical Therapy (PT), and Occupational Therapy (OT). Secondary outcomes included evaluation of disparities in medical comorbidities and preventive healthcare utilization.

Results: Pre-matched cohort analyses include IDC (n = 63,804) and IDAAL (n = 26,645), comprised of 31.8% Latino and 69.0% African American patients. Significant (p < 0.05) differences in medical comorbidities (% prevalence) include obesity (8.9% vs 11.0%), diabetes mellitus (8.4% vs 9.8%), major depressive disorder (12.2% vs 11.2%), Down syndrome (3.1% vs 2.1%), Cerebral Palsy (9.3% vs 10.0%), developmental disorders of speech and language (6.2% vs 7.5%), osteoporosis (3.6% vs 1.8%), and paraplegia/quadriplegia (2.0% vs 2.3%). Post-propensity score matching for age, gender, and paralytic/spastic movement disorders, utilization rates (% Risk, Risk Ratio, [95% Risk Confidence Interval]) were: PM&R services (16.6% vs 14.5%, 1.149, [1.103, 1.196]), PT (17.5% vs 14.5%, 1.206, [1.159, 1.256]), and OT (12.8% vs 11.0 %, 1.156, [1.102, 1.212]).

Conclusions: The findings highlight significant racial disparities in rehabilitative service utilization among adults with ID, with Black and Hispanic patients experiencing lower access despite similar or greater medical comorbidities. These results underscore the need for prospective research and targeted interventions to promote equitable healthcare access.