Suicide mortality in metabolic dysfunction-associated liver diseases: a nationwide cohort study.

For hospitalized older adults, a growing body of evidence shows that mobility programs can lead to improvements in physical activity during hospitalization and in long-term physical function. One such program, STRIDE (AssiSTed eaRly mobIlity for hospitalizeD older vEterans), has consistently been linked to discharge to home rather than a skilled nursing facility for hospitalized older adult US military veterans. In the context of these gains in our understanding of the importance of mobility during hospitalization, evidence continues to demonstrate health inequities in discharge and function posthospitalization. It is possible that these inequities in discharge and posthospitalization functioning may be mitigated by improving access to mobility and rehabilitative health services during hospitalization. In addition, in regard to the ways in which reach of services for mobility and rehabilitation are studied, there have been growing calls for attention to health equity and social drivers of health within implementation studies. Thus, there remains a critical need to understand how social drivers of health and health equity (ie, how health care resources and opportunities are distributed and accessed) may impact reach during implementation of programs designed to improve mobility during hospitalization. Prior research has documented health inequities among older adults during and after acute hospitalization. For example, Black non-Hispanic/Latino/a (NH) individuals are less likely than White NH individuals to receive inpatient rehabilitation services. Past research has shown that cognitive biases influence decision-making in older adults’ postacute care. Through qualitative methodology, researchers found that the combination of 3 highly frequent cognitive biases—authority bias (the tendency to assume that an authority figure’s opinion is more accurate), the halo effect (the tendency to make positive global assumptions about a person/thing due to 1 positive trait), and framing bias (the tendency to let loss/gain framing influence decision-making)—could influence decision-making around access to rehabilitation services during inpatient hospitalization. Posthospitalization, there are also racial inequities in access to rehabilitation therapy such that Black NH and Hispanic/Latino/a older adults average fewer minutes of physical and occupational therapy per week. Following acute hospitalization, Black NH and Hispanic/Latino/a older adults had lower discharge functional status than their White NH counterparts. Studies of Medicare claims data have also shown health inequities in the delivery of physical and occupational therapy services during inpatient stays. One study investigated associations between social drivers of health and the odds of receiving in-hospital physical therapy or occupational therapy among older adults during an acute stay in the intensive care unit. Findings indicated that odds of receiving any physical or occupational therapy during a hospital stay were lower for older adults who were dually eligible for Medicare and Medicaid (which has previously been linked to functional decline) and those who lived rurally. Another study investigated the link between social drivers of health and hospital-based rehabilitation services among older adults hospitalized for stroke. This study found that, at the patient level, the odds of receiving rehabilitation services were lower for those who were dually enrolled in Medicare and Medicaid; whereas, at the hospital level, the odds of receiving rehabilitation services were lower at nonrural facilities.