Article

OBJECTIVE: To investigate the impact of physiotherapy (PT) and occupational
therapy (OT) services on long-stay home care patients with musculoskeletal
disorders. DESIGN: Observational study. SETTING: Home care programs.
PARTICIPANTS: All long-stay home care patients between 2003 and 2008 (N=99,764)
with musculoskeletal disorders who received a baseline Resident Assessment
Instrument for Home Care assessment, 1 follow-up assessment, and had discharge or
death records. INTERVENTIONS: PT and OT. MAIN OUTCOME MEASURES: The effects of PT
and OT services on transitions in functional state, discharge from home care with
service plans complete, institutionalization, and death were assessed via
multistate Markov models. RESULTS: Home care patients with deficiencies in
instrumental activities of daily living and/or activities of daily living at
baseline and who received home-based rehabilitation had significantly increased
odds of showing functional improvements by their next assessment (for a state 3
to state 2 transition: odds ratio [OR]=1.17; 95% confidence interval [CI],
1.10-1.26; P<.0001; for a state 2 to state 1 transition: OR=1.36; 95% CI,
1.14-1.61; P=.0005). Receipt of PT/OT also significantly reduced the odds of
mortality and institutionalization in this group. CONCLUSIONS: With increasing
numbers of older adults with chronic conditions and limited funding for health
care services, it is essential to provide the right services at the right time in
a cost-effective manner. Long-stay home care patients who receive rehabilitation
at home have improved outcomes and lower utilization of costly health services.
Our findings suggest that investment in PT and OT services for relatively short
periods may provide savings to the health care system over the longer term.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS