Physical therapy use by community-based older people.
OBJECTIVE
Little information is available on factors associated with physical therapy use. Identifying the characteristics of people who use physical therapy and some of the factors associated with its use is a useful first step in determining whether disparities exist in physical therapy use. The purpose of this study was to identify factors associated with physical therapy use by community-based older people.


METHODS
The subjects were community-based people 65 years of age or older who participated in the Medicare Current Beneficiary Survey and had at least one physician encounter (N=38,312 person-years across 20,227 individuals).


METHODS
Logit and ordinary least squares regression analyses were conducted to identify factors associated with physical therapy use.


RESULTS
Several measures of health and function were associated with physical therapy use. Several demographic, insurance, and geographic characteristics also were associated with physical therapy use. Income, education, having supplemental private insurance, participating in a managed care plan, and physical therapist supply were positively associated with physical therapy use. Age was negatively associated with physical therapy use. For people who saw a physical therapist, amount of physical therapy received was positively associated with income, having supplemental private insurance, living in a metropolitan area, physical therapist supply, and being African American. Amount of physical therapy received was negatively associated with being in a managed care plan.


CONCLUSIONS
Variation in physical therapy use, explained by factors other than need, suggests potential underuse or overuse of physical therapy by community-based older people.
Freburger
Janet K
JK
Cecil G Sheps Center for Health Sciences Research, University of North Carolina, Chapel Hill, NC 27599, USA. janet_freburger@unc.edu
Holmes
George M
GM
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006297:Health Services Accessibility; D006300:Health Services Misuse; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D006278:Medicare; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012307:Risk Factors; D014481:United States