Article

Medicare beneficiaries frequently receive physical therapy for
musculoskeletal conditions.
Little information is available about this care.
The purposes of this study were: (1) to describe characteristics,
clinical outcomes, and utilization for Medicare beneficiaries receiving physical
therapy in outpatient clinics within one integrated health care system; (2) to
compare characteristics, outcomes, and utilization based on the body region
affected; and (3) to examine factors predictive of outcomes and utilization.
This was a prospective, longitudinal study. METHODS: Medicare
beneficiaries aged 65 years or older (n=1,840 episodes of care) participated in
the study. Descriptive statistics were calculated for patient characteristics and
outcomes. Comparisons were made based on body region. Regression models evaluated
factors associated with change in pain, improved outcome, and utilization.
RESULTS: The patients' mean age was 74.2 years (SD=6.3), and 65.3% were female.
The most common body regions were the lumbar spine, shoulder, and knee,
collectively accounting for 71.3% of the episodes of care. Patients attended a
mean of 6.8 visits (SD=4.7), and 63.9% experienced an improved outcome. Episodes
of care for lumbar spine conditions had less reduction in pain, whereas shoulder
conditions and foot/ankle conditions showed the greatest improvement. Care for
hip conditions was least likely to result in an improved outcome. Knee conditions
were most likely to have an improved outcome. Care for shoulder and knee
conditions had the highest number of visits. Factors associated with greater
reduction in pain and improved outcomes included greater initial pain or
disability and attending more visits. Factors associated with greater utilization
included a postsurgical condition and higher initial pain rating. Limitations
The study was performed in one geographic region within a single health care delivery
system. CONCLUSION: The results provide information on outcomes of physical
therapy for Medicare beneficiaries in one health care system. Further research is
needed to examine optimal utilization and care for these patients.

Langue : ANGLAIS