Unveiling the Impact of Occupational Therapy on Acute Care Outcomes: A Machine Learning Approach.
Mi Jung Lee, Joshua K Johnson, Anna Marchiando and 2 others
PMID 41283864WHAT IT FOUND
OT service patterns were linked with 30-day readmission and daily-activity gains in orthopedic patients, but not with discharge to home.
More total OT minutes were linked with higher readmission, so these are observational patterns, not proven treatment effects.
Key findings
01OT-related variables were not selected in the model predicting discharge to home; the model used PT mobility score, length of stay, home assistance, living conditions, prior function, age, and PT minutes.
02Patients with short stays and high comorbidity had higher 30-day readmission risk when OT visits occurred on less than 67% of hospital days.
03For daily-activity improvement, the model identified patterns including 3 or more OT visits when first daily-activity score was below 30, OT visits on 82% or more of days when PT visits were frequent, and 39 or more OT minutes in another subgroup.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a retrospective cohort study, not a randomised trial, so it cannot show that OT caused the outcomes. The analysis included only patients who received OT, so it cannot compare them with patients who received no OT. Patients also received PT and other acute-care services, so the independent contribution of OT cannot be separated from those treatments. The study used current OT allocations from one health care system with a limited number of OT practitioners, so results may not generalize. Patients received 1.4 OT sessions on average, more than 70.8% received only 1 session, and 71.1% did not receive follow-up evaluations, so the daily-activity improvement results represent the remaining 28.9% of patients. Readmissions were tracked only within the 11-hospital system, so patients readmitted elsewhere were missed. The minimal detectable change cutoff used for daily activities was developed for neurologic conditions, which may not fit orthopedic patients. The study did not analyse the content of OT sessions, so number, minutes, and frequency may not capture what actually helped.
Declared interests
The supplied text does not state funding or conflicts of interest; the publication types list non-U.S. government research support.
The easy way to misread this
Do not treat these OT patterns as proof that adding OT visits improves outcomes. The study did not assign OT, included PT and other care, and OT variables were not selected for home discharge.