@article{ref1,
title="The relationship between fall risk and hospital-based therapy utilization is moderated by demographic characteristics and insurance type",
journal="Archives of physical medicine and rehabilitation",
year="2020",
author="Malcolm, Matt P. and Hoffman, Amanda and Sharp, Julia and Graham, James E. and Kinney, Adam R.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To investigate whether indicators of patient need (comorbidity burden; fall risk) predict acute care rehabilitation utilization, and whether this  relationship varies across patient characteristics (i.e., demographic  characteristics; insurance type). <br><br>DESIGN: Secondary analysis of electronic health  records (EHR) data. SETTING: Five acute care hospitals. PARTICIPANTS: 110,209 adults  admitted to five regional hospitals between 2014 and 2018. INTERVENTIONS: Not  applicable. MAIN OUTCOME MEASURES: Occupational therapy (OT) and physical therapy  (PT) utilization. Logistic regression models determined whether indicators of  patient need predicted OT and PT utilization. Interactions between indicators of  need and both demographic factors (e.g., minority status; presence of significant  other) and insurance type were included to investigate whether the relationship  between patient need and therapy access varied across patient characteristics. <br><br>RESULTS: Greater comorbidity burden was associated with a higher likelihood of  receiving OT and PT. Relative to those with low fall risk, those with moderate and  high fall risk were more likely to receive OT and PT. The relationship between fall  risk and therapy utilization differed across patient characteristics. Among patients  with higher levels of fall risk, those with a significant other were less likely to  receive OT and PT; significant other status did not explain therapy utilization  among patients with low fall risk. Among those with high fall risk, patients with VA  insurance and minority patients were more likely to receive PT than those with  private insurance and non-minority patients, respectively. Insurance type and  minority status did not appear to explain PT utilization among those with lower fall  risk. <br><br>CONCLUSIONS: Patients with greater comorbidity burden and fall risk were more  likely to receive acute care rehabilitation. However, the relationship between fall  risk and utilization was moderated by insurance type, having a significant other,  and race/ethnicity. Understanding the implications of these utilization patterns  requires further research.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2020.12.005",
url="http://dx.doi.org/10.1016/j.apmr.2020.12.005"
}