Rehabilitation Utilization for Falls Among Community-Dwelling Older Adults in the United States in the National Health and Aging Trends Study.
Briana L Moreland, Laura L Durbin, Judith D Kasper and 1 others
PMID 29545001WHAT IT FOUND
Recurrent falls strongly predict receiving fall-related rehabilitation, but lower education and Hispanic ethnicity reduce access even after accounting for falls.
Therapists should not assume clinical need alone drives referrals, as demographic barriers persist.
Key findings
01Participants with multiple falls in the past year had 14.21 times the odds of receiving fall-related rehabilitation compared to non-fallers.
02Hispanic participants were significantly less likely to receive fall-related rehabilitation compared to white non-Hispanic participants.
03Participants with less than a high school diploma were significantly less likely to receive fall-related rehabilitation compared to those with a bachelor's degree.
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 analysis was cross-sectional, so it cannot determine the duration or timing of rehabilitation access relative to falls. Falls and rehabilitation utilization were self-reported, which introduces recall bias and may lead to underestimation of falls. The study did not measure distance to providers or specific insurance coverage details, which are known barriers to care. Participants who did not respond to rehabilitation questions were excluded, potentially introducing selection bias.
Declared interests
The study was sponsored by the National Institute on Aging and conducted by Johns Hopkins Bloomberg School of Public Health. No specific financial conflicts of interest for the authors were declared in the provided text.
The easy way to misread this
Do not interpret the strong association between recurrent falls and rehabilitation utilization as evidence that rehabilitation reduces falls. This study describes who receives care, not whether the care is effective. Additionally, do not assume that clinical severity alone drives referrals, as demographic factors like ethnicity and education significantly influence access independent of fall history.