Patient-related predictors of rehabilitation use for community-dwelling older Americans.
OBJECTIVE
To determine patient factors that predict use of physical or occupational therapy (PT/OT) services by elderly people.


METHODS
Time-series study of the relationship of PT/OT use to a variety of characteristics present at baseline.


METHODS
Eight-hundred nine community-dwelling men and women aged 65 and older.


METHODS
The Medicare Screening and Health Promotion Trial at UCLA.


METHODS
Use of PT/OT services, as reported in a telephone survey 1 year after initial information was obtained on the same subjects by the baseline telephonic survey.


RESULTS
Fifteen percent of the sample used PT/OT within 12 months of baseline. In multiple logistic regression analysis, PT/OT use was significantly less frequent among racial minorities, less well educated groups, and the oldest age group. PT/OT use was higher among those who had both functional disability and the presence of arthritis, heart or lung disease, or a prior history of stroke. However, neither functional disability alone nor the presence of arthritis, cardiovascular or lung disease, in the absence of limited functioning, was associated with PT/OT use. Patients who had obtained a pneumococcal vaccination or used transportation services were also more likely to receive PT/OT.


CONCLUSIONS
Our findings suggest that there may be important sociodemographic inequalities in the use of rehabilitation services and raise the possibility of inappropriate underuse in certain subgroups. Additional studies are needed to determine whether similar inequalities of PT/OT use are found in other populations and whether rehabilitation is effective in various subgroups.
Mayer-Oakes
S A
SA
Department of Medicine/Geriatrics, University of California, Los Angeles 90024-1687.
Hoenig
H
H
Atchison
K A
KA
Lubben
J E
JE
De Jong
F
F
Schweitzer
S O
SO
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D015438:Health Behavior; D006297:Health Services Accessibility / Q000592:standards; D006301:Health Services Needs and Demand / Q000592:standards; D006302:Health Services Research; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008603:Mental Health; D008913:Minority Groups; D009788:Occupational Therapy / Q000592:standards / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities / Q000592:standards / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011314:Preventive Health Services / Q000592:standards; D044469:Racial Groups