| Titre : | Did Clarification of Medicare Guidelines Change Outpatient Physical Therapy and Occupational Therapy Usage? A Retrospective Analysis (2019) |
| Auteurs : | Justine Dee ; Benjamin Littenberg |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 100, n° 1, 2019) |
| Article en page(s) : | p. 78-85 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Ergothérapie ; Rééducation et réadaptation |
| Mots-clés: | Health expenditures ; Dépenses de santé ; Health services for the aged ; Services de santé pour personnes âgées ; Linear models ; Modèles linéaires ; Logistic models ; Modèles logistiques ; Medicare Part B ; Medicare part B (USA) ; Occupational therapy ; Odds ratio ; Physical therapy modalities ; Techniques de physiothérapie |
| Résumé : |
Objective To determine if there was a change in the number of outpatient physical therapy (PT) and occupational therapy (OT) visits for Medicare beneficiaries, and in the number of beneficiaries receiving extended courses of >12 therapy visits, after the Jimmo vs Sebelius settlement. Design Cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) comparing calendar years 2011-2012 to 2014-2015. Setting Community in-home survey. Participants Medicare Part-B recipients who received outpatient PT/OT (N=1183, median age 70.8) during pre–Jimmo settlement (2011-2012) and post–Jimmo settlement (2014-2015) time periods. Intervention Not applicable. Main Outcome Measures Number of therapy visits/patient/year and number of subjects who received >12 therapy visits/year estimated by linear and logistic regressions controlling for potential confounders (age, body mass index [BMI], and geographic region). Results The unadjusted median number of therapy visits/year increased from 7 to 8 after the settlement. Linear regression estimated a 1.02 increase in the number of therapy visits after the settlement (95% confidence interval [CI] 0.23, 1.80; P=.01). The odds of having >12 therapy visits/year increased (odds ratio=1.41; 95% CI 1.02,1.96; P=.04). We observed a significant interaction between race and the effect of the settlement on the odds of having >12 therapy visits (OR 3.64; 95% CI 1.58, 8.39). Non-Hispanic white subjects saw an increase in utilization while a combined group of black, Hispanic and Asian subjects’ utilization declined. Conclusion Utilization of outpatient PT/OT changed after the 2013 Jimmo settlement. Further research is needed to determine the effect on patient outcomes and cost. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999318311717 |
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