@article{ref1,
title="Prevalence and predictors of ambulatory care physicians' documentation of mobility limitations in older adults",
journal="Archives of physical medicine and rehabilitation",
year="2023",
author="Shuman, Valerie and Brach, Jennifer S. and Bean, Jonathan F. and Freburger, Janet K.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To determine how often physicians document mobility limitations in visits with older adults, and which patient, physician, and practice characteristics associate with documented mobility limitations. <br><br>DESIGN: We completed a cross-sectional analysis of National Ambulatory Medical Care Surveys, years 2012-2016. Multivariate analyses were conducted to identify patient, physician, and practice-level factors associated with mobility limitation documentation. SETTING: Ambulatory care visits. PARTICIPANTS: We analyzed visits with adults 65 years and older. Final sample size represented 1.3 billion weighted visits. INTERVENTION: N/A MAIN OUTCOME MEASURE: We defined the presence/absence of a mobility limitation by whether any ICD-9 or ICD-10 code related to mobility limitations were documented in the visits. <br><br>RESULTS: The overall prevalence of mobility limitation documentation was 2.4%. The most common codes were falls-related. Patient-level factors more likely to be associated with mobility limitation documentation were visits by individuals over 85 years of age, relative to 65-69 years, (OR 2.32, 95% CI 1.76-3.07]; with a comorbid diagnosis of arthritis (OR 1.35, 1.18-2.01); and with a comorbid diagnosis of cerebrovascular disease (OR 1.60, 1.13-2.26). Patient-level factors less likely to be associated with mobility limitation documentation were visits by males (OR 0.80, 0.64-0.99); individuals with a cancer diagnosis (OR 0.76, 0.58-0.99); and by individuals seeking care for a chronic problem (relative to a new problem [OR 0.36, 0.29-0.44]). Physician-level factors associated with an increased likelihood of mobility limitation documentation were visits to neurologists (ORs 4.48, 2.41-8.32) and orthopedists (OR 2.67, 1.49-4.79) compared to primary care physicians. At the practice-level, mobility documentation varied based on the percentage of practice revenue from Medicare. <br><br>CONCLUSIONS: Mobility limitations are under-documented and may be primarily captured when changes in function are overt.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2022.11.018",
url="http://dx.doi.org/10.1016/j.apmr.2022.11.018"
}