Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland, USA.
Phys Ther. 2011 Jul;91(7):1018-29. doi: 10.2522/ptj.20100343. Epub 2011 May 12.
Comprehensive information on determinants and patterns of use and spending for ambulatory physical therapy services is needed to inform health planning and policy decisions. Most research in the literature on this topic is limited to specific payers, age groups, and conditions.
The purpose of this study was to examine factors associated with the resource intensity of physical therapy episodes for adults in the United States as measured by number of visits and expenses per visit.
This study was a secondary analysis of longitudinal survey data from the Medical Expenditure Panel Survey (MEPS) panels 9, 10, and 11.
An analytic file was created based on data from the longitudinal data files for 3 MEPS panels and the annual office-based and hospital outpatient event files. A total of 1,377 episodes of physical therapy care were identified. Variation in both the total number of visits per episode and expenses per visit was examined by fitting regression models to evaluate the effects of selected independent variables classified into 4 categories: episode-level variables, demographic characteristics, geographic variables, and health status indicators.
Average total expenses per episode (in 2007 dollars) were $1,184 (median=$651), with an average number of visits per episode of 9.6 (median=6.0) and average expenses per visit of $130 (median=$95). Significant variation by geographic characteristics, sex, and one comorbid condition (high blood pressure) was found in the number of visits model. In the expenditures model, expenses per visit were associated with age/insurance coverage, setting (hospital outpatient versus office based), primary condition category, and mental health status. Limitations Limitations include limited sample sizes of physical therapy users and lack of detailed clinical information.
Variability in the resource intensity of physical therapy episodes is influenced to some degree by nonclinical variables.
为了为卫生规划和政策决策提供信息，需要全面了解决定和使用门诊物理治疗服务的模式和支出的因素。文献中关于这个主题的大多数研究都仅限于特定的付款人、年龄组和条件。
本研究旨在研究与美国成年人物理治疗发作资源强度相关的因素，该资源强度通过就诊次数和每次就诊费用来衡量。
这是对医疗支出面板调查（MEPS）第 9、10 和 11 面板的纵向调查数据进行的二次分析。
根据来自 3 个 MEPS 面板的纵向数据文件以及年度门诊和医院门诊事件文件创建了分析文件。共确定了 1377 例物理治疗护理发作。通过拟合回归模型来检查每个发作的总就诊次数和每次就诊费用的变化，以评估按 4 类分类的选定自变量的影响：发作水平变量、人口统计学特征、地理变量和健康状况指标。
每个发作的平均总费用（2007 年美元）为 1184 美元（中位数为 651 美元），平均每个发作的就诊次数为 9.6 次（中位数为 6.0 次），每次就诊的平均费用为 130 美元（中位数为 95 美元）。就诊次数模型中发现了地理位置、性别和一种合并症（高血压）的显著差异。在支出模型中，每次就诊的费用与年龄/保险范围、就诊地点（医院门诊与门诊）、主要疾病类别和心理健康状况有关。局限性包括物理治疗使用者的样本量有限和缺乏详细的临床信息。
物理治疗发作的资源强度的可变性在某种程度上受到非临床变量的影响。
