Article

Comprehensive information on determinants and patterns of use and
spending for ambulatory physical therapy services is needed to inform health
planning and policy decisions. Most research in the literature on this topic is
limited to specific payers, age groups, and conditions. OBJECTIVE: The purpose of
this study was to examine factors associated with the resource intensity of
physical therapy episodes for adults in the United States as measured by number
of visits and expenses per visit. DESIGN: This study was a secondary analysis of
longitudinal survey data from the Medical Expenditure Panel Survey (MEPS) panels
9, 10, and 11. METHODS: An analytic file was created based on data from the
longitudinal data files for 3 MEPS panels and the annual office-based and
hospital outpatient event files. A total of 1,377 episodes of physical therapy
care were identified. Variation in both the total number of visits per episode
and expenses per visit was examined by fitting regression models to evaluate the
effects of selected independent variables classified into 4 categories:
episode-level variables, demographic characteristics, geographic variables, and
health status indicators. RESULTS: Average total expenses per episode (in 2007
dollars) were $1,184 (median=$651), with an average number of visits per episode
of 9.6 (median=6.0) and average expenses per visit of $130 (median=$95).
Significant variation by geographic characteristics, sex, and one comorbid
condition (high blood pressure) was found in the number of visits model. In the
expenditures model, expenses per visit were associated with age/insurance
coverage, setting (hospital outpatient versus office based), primary condition
category, and mental health status. Limitations Limitations include limited
sample sizes of physical therapy users and lack of detailed clinical information.
CONCLUSIONS: Variability in the resource intensity of physical therapy episodes
is influenced to some degree by nonclinical variables.

Langue : ANGLAIS