Prevalence and Characteristics of Prehabilitation Utilization Among Older Medicare Beneficiaries Undergoing Elective Inpatient Lower Extremity Joint Replacement.
Jenni S Reiff, Jennifer L Wolff, John McGready and 3 others
PMID 40680810WHAT IT FOUND
Only 9.53% of older Medicare patients undergoing elective hip or knee replacement received prehabilitation.
Most received a single outpatient physical therapy visit. Pre-frail patients and those with more chronic conditions were less likely to receive these services.
Key findings
01Prehabilitation was received by 9.53% of the 196,690 beneficiaries, rising from 8.03% in 2016 to 11.14% in 2019.
02The typical prehabilitation episode consisted of a single outpatient physical therapy visit initiated 14 days before surgery.
03Patients who were pre-frail, male, non-white, Medicaid-eligible, or had more chronic conditions had lower adjusted odds of receiving prehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relied on billing codes, which may misclassify routine therapy as prehabilitation or miss unbilled prehabilitation services. The definition of prehabilitation was limited to in-person services within 30 days of surgery, potentially excluding earlier or virtual interventions. The data did not include clinical factors like pain levels, functional status, or patient preferences, which likely influence whether a patient receives therapy.
Declared interests
The authors disclosed no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not assume that the observed increase in prehabilitation utilization reflects a change in clinical best practices or improved patient outcomes. The study describes what was billed, not whether the single visits provided were effective or sufficient for surgical recovery.
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