Utilization of Rehabilitation Services in Stroke: A Study Utilizing the Health and Retirement Study With Linked Medicare Claims Data.
Karen M Keptner, Kathleen Smyth, Siran Koroukian and 2 others
PMID 31421093WHAT IT FOUND
Among older Medicare stroke survivors, only 21.6% reported rehabilitation at first poststroke interview.
Older age and a second stroke were linked to more use.
Key findings
01At the first interview post stroke, 21.6% of stroke survivors reported receipt of rehabilitation services.
02In the final model, age and having a second stroke were significant predictors, while having an undefined stroke trended toward statistical significance.
03With each year of increased age, participants were 1.14 times more likely to participate, and those with a second stroke were 1.64 times more likely.
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 used existing survey and claims data, so it could not examine all issues that may affect rehabilitation use. Participants reported lifestyle and health information themselves, which can be inaccurate. The sample was older than the original survey sample because Medicare mainly covers people over 65. The study looked at rehabilitation broadly and did not separate occupational therapy from physical therapy. Some patients may have needed only physical therapy or only occupational therapy, but the study did not capture that. Utilization rates may have been affected because 10% to 15% of each wave was lost to follow-up. The study used Medicare fee-for-service claims, so results may not apply to newer payment structures.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. The publication types list research support from N.I.H., Extramural.
The easy way to misread this
Do not conclude that physical therapy or occupational therapy was underused. The study measured rehabilitation broadly and did not separate the 2 services.