Use of Physical and Occupational Therapists Following Stroke: Transitioning from the Acute Care to Community Setting

June 29, 2016

Janet K. Freburger, PT, PhD; Dongmei Li, MS; Anna Johnson, PhD; 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



  1. Describe the use of PTs & OTs from the acute to community setting following stroke.
  2. Identify predictors of therapist use, continuity of care, and early care particularly in regard to:
    • contextual factors that are potentially modifiable.
    • sociodemographic factors indicative of disparities.

Conclusions and Significance

  • Underuse of therapists in first 30 days after discharge home following stroke.
  • Continuity of care from the acute to community setting also low.
  • Patients seen at hospitals with higher RN staffing levels and living in counties with greater PCP supply were more likely to: a) receive therapist care in the inpatient and outpatient settings; b) have continuity of care across the inpatient and outpatient setting; and c) receive early therapist care.
  • Physician specialist and PT supply associated with use in some models.
  • Socioeconomic and racial disparities in use present particularly in regard to outpatient therapist use and early use.
  • Evidence of not-for-profit and accreditation status being associated with use.
  • Findings have implications for policies to improve PCP supply, modify Medicare payment for outpatient therapy, and improve access for underserved.


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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.