Activities of Daily Living Performance and Use of Occupational Therapy in Acute Care: Moderating Factors

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Am J Occup Ther. January 1, 2022; 76 (1): 7601180040. doi: 10.5014 / ajot.2022.049060.

ABSTRACT

IMPORTANCE: Inpatients who have difficulty performing activities of daily living (ADLs) benefit from occupational therapy services; however, disparities in access to these services are under-studied.

OBJECTIVE: To study whether the need (ie.

DESIGN: A secondary analysis of electronic health record data. Logistic regression models were specified to determine whether ADL performance predicted use of occupational therapy treatment. Interactions were included to determine whether the relationship between ADL performance and occupational therapy use varied by socio-demographic factors (eg, age) and type of insurance.

PARTICIPANTS: A total of 56,022 adults admitted to five regional hospitals between 2014 and 2018 who received an occupational therapy assessment.

INTERVENTION: None. Results and measures: use of occupational therapy services, activity measurement for post-acute care, “6 clicks” measurement of daily activity.

RESULTS: Forty-four percent of patients evaluated for occupational therapy received treatment. Patients with poorer ADL performance were more likely to receive occupational therapy treatment; however, interaction terms indicated that among patients with poor ADL performance, those who were younger, were white and non-Hispanic, had significant other people, and had private (vs public) insurance were more likely to receive treatment. These differences were smaller in patients with better ADL performance.

CONCLUSIONS AND RELEVANCE: Greater need was positively associated with receipt of occupational therapy services, but this relationship was moderated by age, minority status, other significant person status, and type of insurance. The results provide direction for exploring the determinants of disparities in the use of occupational therapy. What this article adds: The use of occupational therapy in acute care is determined in part by patient needs, but potential disparities in access to beneficial services may exist depending on socio-demographic characteristics and type of patient. ‘assurance. Identifying the potential determinants of disparities in the use of occupational therapy in acute care is the first step in developing strategies to reduce barriers for those in need.

PMID: 34997754 | DOI: 10.5014 / adjot.2022.049060


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