Article

OBJECTIVE: To characterize rehabilitation service use among community-dwelling
older adults in the United States by identifying predictors of rehabilitation
utilization, patient-reported functional improvement, and rehabilitation goal
attainment. DESIGN: Cross-sectional analysis of the 2015 National Health and
Aging Trends Study, which used an age-stratified, multistage sampling design and
oversampled blacks and the oldest old (>/=85y). SETTING: Standardized, in-person
home interviews and physical performance testing. PARTICIPANTS: Nationally
representative sample of community-dwelling Medicare beneficiaries (N=7487) aged
>/=65 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rehabilitation
services use (physical therapy, occupational therapy, and speech therapy) across
all settings in the last year, patient-reported functional improvement, and
patient-reported rehabilitation goal attainment. RESULTS: Twenty percent of older
adults reported rehabilitation use in the last year. In a multivariable model,
rehabilitation use was significantly lower among blacks and higher among those
with higher education, chronic medical conditions, pain, history of falls, and
severe limitations in physical performance. Overall, 72% reported functional
improvement during rehabilitation, and 75% reported meeting their goals by
discharge. Improved function was associated with longer duration of
rehabilitation. A significantly lower percentage of older adults with bothersome
pain and severe physical limitations reported meeting rehabilitation goals.
CONCLUSIONS: Most older adults who received rehabilitation reported functional
improvement and meeting rehabilitation goals. However, social disparities were
evident with lower rehabilitation utilization among blacks and those with less
education. Importantly, functional improvement and goal attainment did not vary
by demographics or diagnoses. Longer duration of rehabilitation and improved pain
management may be necessary for functional improvement and goal attainment.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- Etats Unis

Langue : ANGLAIS