Article

The purpose of this study was to characterize the intervention type delivered to
individuals with cerebral palsy (CP) in a pediatric outpatient medical setting
and to identify factors associated with the total amount of service within each
type. Four hundred and twenty-five individuals with CP (1-33 years) Gross Motor
Function Classification System (GMFCS): Level I (n = 152); II (n = 63); III (n =
55); IV (n = 80); and V (n = 75). Billing code data was extracted retrospectively
from 2008 medical records and categorized to reflect four types: body structures
and function (BSF), activity (ACT), environment (ENV), and examination (EXAM).
Age at first visit, type of insurance at first visit and GMFCS level was also
collected. The majority (47%) of the PT delivered was categorized as activity
based units, 25% as body structure and function, 21% as environment, and 7% as
examination. Significant differences were found in: total BSF therapy units among
GMFCS (p = 0.008) and insurance type (p < 0.001), ACT units among GMFCS (p <
0.001), age groups (p < 0.001), and insurance type (p = 0.008), and ENV units
among GMFCS (p = 0.04). The amount of variability (R(2)) explained by the model
for each category BSF, ACT, and ENV was 0.09 (p < 0.0001), 0.15 (p < 0.0001) and
0.02 (p = 0.04), respectively. Variations in amount of services received among
types of intervention are associated with child and environmental
characteristics. Low R(2) values indicate the need to collect information on
other factors that influence service delivery. Data that are standardized and
reliably collected should be validated and compared across institutions to
support larger studies of service delivery patterns.

Langue : ANGLAIS