Mobility Status and Acute Care Physical Therapy Utilization: The Moderating Roles of Age, Significant Others, and Insurance Type

Kinney, Adam R.; Graham, James E.; Middleton, Addie; Edelstein, Jessica; Wyrwa, Jordan M; Malcolm, Matthew P.

doi:10.1016/j.apmr.2021.12.013

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…Most notably, we had no measure of functional status, which is the most common reason for a PT consult 36 and which may interact with variables that we did include. For example, findings from Kinney et al 37 demonstrate that functional status and age interact such that younger patients (not older patients, as we found) were more likely to receive PT. The discrepancy between our findings and those of Kinney et al may partially be explained by the inclusion in our study of patients only with pneumonia, which is more common in older adults and more debilitating for older patients.…”

Section: Discussionsupporting

confidence: 50%

Physical therapy provision for patients with pneumonia in US hospitals

Johnson,

Young,

Guo

et al. 2023

Journal of Hospital Medicine

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BackgroundPhysical therapy (PT) appears beneficial for hospitalized patients. Little is known about PT practice patterns and costs across hospitals.ObjectiveTo examine whether receiving PT is associated with specific patient and hospital characteristics for patients with pneumonia. We also explored the variability in PT service provision and costs between hospitals.MethodsWe included administrative claims from 2010 to 2015 in the Premier Healthcare Database, inclusive of 644 US hospitals. We examined associations between receiving at least one PT visit and patient (age, race, insurance, intensive care utilization, comorbidity status, and length of stay) and hospital (academic status, rurality, size, and location) characteristics. Exploratory measures included timing and proportion of days with PT visits, and per‐visit and per‐admission costs.ResultsOf 768,010 patients, 49% had PT. After adjustment, older age most significantly increased the probability of receiving PT (+38.0% if >80 vs. ≤50 years). Higher comorbidity burden, longer length of stay, and hospitalization in an urban setting were also associated with higher probability. Hospitalization in the South most significantly decreased the probability (−9.1% vs. Midwest). Patients without Medicare and Non‐White patients also had lower probability. Median (interquartile range) days to first visit was 2 (1–4). Mean proportion of days with a visit was 35% ± 20%. Median per‐visit cost was $88.90 [$56.70–$130.90] and per‐admission was $224.00 [$137.80–$369.20].ConclusionBoth clinical (intensive care utilization and comorbidity status) and non‐clinical (age, race, rurality, location) factors were associated with receiving PT. Within and between hospitals, there was high variability in the number and frequency of visits, and costs.

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