Use of Physical and Occupational Therapy Following Stroke and Risk of Re-Hospitalization

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June 29, 2016

Janet K. Freburger, PT, PhD; Dongmei Li, MS; Erin P. Fraher, PhD, MPP

Poster presentation, 2016 AcademyHealth Annual Research Meeting and 2016 CoHSTAR Summer Institute on Health Services Research

Carolina HWRC Project: The Role of Physical and Occupational Therapists in the Acute to Post-Acute Care Transition

           

Objectives:

  • To examine the relationship between the use of physical and occupational therapists (PTs & OTs) in the first 30 days following discharge home after stroke and subsequent re-hospitalizations.

Conclusions and Significance

  • Relative to stroke survivors who received no therapy, those who received outpatient therapy were less likely to be hospitalized in the first 60 days of follow-up. A similar trend, though non-significant, was observed for hospitalization in the first 30 days of follow-up.
  • While the point estimates were imprecise, there was
    • suggestion of a dose-response relationship for 1-9 therapy visits and risk of rehospitalization in the first 30 days of follow-up.
    • suggestion that home health therapy starting 3-6 days after discharge home decreased the risk of rehospitalization relative to those who received therapy more than 14 days after discharge.
  • Although the sample size for this analysis was relatively large overall, it was underpowered for some of the subgroup analyses and for the visits and time to therapy analyses due to the low prevalence of rehospitalization and the relatively low use of therapy.
  • Further work is needed to understand the role of therapists in reducing hospitalization and downstream healthcare costs following stroke.

           

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This work is funded through cooperative agreement U81HP26495, Health Workforce Research Centers, with the National Center for Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration, U.S. Department of Health and Human Services. The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.