Variation in Utilization of Physical Therapist and Occupational Therapist Services After Rotator Cuff Repair: A Population-Based Study.

Autor:	Stern, Brocha Z, Zubizarreta, Nicole, Anthony, Shawn G, Gladstone, James N, Poeran, Jashvant
Předmět:	MEDICAL care use HEALTH attitudes MEDICAL quality control STATISTICAL hypothesis testing POPULATION health RETROSPECTIVE studies MULTIVARIATE analysis POPULATION geography DESCRIPTIVE statistics LONGITUDINAL method ODDS ratio ROTATOR cuff injuries STATISTICS PHYSICAL therapy services CONFIDENCE intervals DATA analysis software OCCUPATIONAL therapy services
Zdroj:	PTJ: Physical Therapy & Rehabilitation Journal; Apr2024, Vol. 104 Issue 4, p1-10, 10p
Abstrakt:	Objective The objective of this study was to describe the utilization of physical therapist and occupational therapist services after rotator cuff repair (RCR) and examine variation in rehabilitation characteristics by profession. Methods This retrospective cohort study used the IBM MarketScan Commercial Claims and Encounters database. Eligible patients were 18 to 64 years old and had undergone outpatient RCR between 2017 and 2020. Physical therapist and occupational therapist services were identified using evaluation and treatment codes with profession-specific modifiers ("GP" or "GO"). Factors predicting utilization of formal rehabilitation and physical therapist versus occupational therapist services were examined; and univariable and multivariable analyses of days to initiate therapy, number of visits, and episode length by profession were completed. Results Among 53,497 patients with an RCR, 81.2% initiated formal rehabilitation (93.8% physical therapist, 5.2% occupational therapist, 1.0% both services). Patients in the Northeast and West (vs the South) were less likely to receive rehabilitation (odds ratio [OR] = 0.67 to 0.70) and less likely to receive occupational therapist services (OR = 0.39). Patients living in the Midwest (versus the South) were less likely to receive rehabilitation (OR = 0.79) but more likely to receive occupational therapist services (OR = 1.51). Similarly, those living in a rural (versus urban) area were less likely to utilize rehabilitation (OR = 0.89) but more likely to receive occupational therapist services (OR = 2.21). Additionally, receiving occupational therapist instead of physical therapist services was associated with decreased therapist visits (−16.89%), days to initiate therapy (−13.43%), and episode length (−13.78%). Conclusion Most patients in our commercially insured cohort utilized rehabilitation services, with a small percentage receiving occupational therapist services. We identified profession-specific variation in utilization characteristics that warrants further examination to understand predictors and associated outcomes. Impact Variation in rehabilitation utilization after RCR, including profession-specific and regional differences, may indicate opportunities to improve standardization and quality of care. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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