Adam R. Kinney, PhD, OTR/L, is Research Health Science Specialist, Rocky Mountain Mental Illness Research, Education, and Clinical Center, Department of Veterans Affairs, Aurora, CO, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora;
James E. Graham, PhD, DC, FACRM, is Professor, Department of Occupational Therapy, and Director, Center for Community Partnerships, Colorado State University, Fort Collins.
Am J Occup Ther. 2022 Jan 1;76(1). doi: 10.5014/ajot.121.049060.
Hospitalized patients who have difficulty performing activities of daily living (ADLs) benefit from occupational therapy services; however, disparities in access to such services are understudied.
To investigate whether need (i.e., limited ADL performance) predicts acute care occupational therapy utilization and whether this relationship differs across sociodemographic factors and insurance type.
A secondary analysis of electronic health records data. Logistic regression models were specified to determine whether ADL performance predicted use of occupational therapy treatment. Interactions were included to investigate whether the relationship between ADL performance and occupational therapy utilization varied across sociodemographic factors (e.g., age) and insurance type.
A total of 56,022 adults admitted to five regional hospitals between 2014 and 2018 who received an occupational therapy evaluation.
None. Outcomes and Measures: Occupational therapy service utilization, Activity Measure for Post-Acute Care "6-Clicks" measure of daily activity.
Forty-four percent of the patients evaluated for occupational therapy received treatment. Patients with lower ADL performance were more likely to receive occupational therapy treatment; however, interaction terms indicated that, among patients with low ADL performance, those who were younger, were White and non-Hispanic, had significant others, and had private insurance (vs. public) were more likely to receive treatment. These differences were smaller among patients with greater ADL performance.
Greater need was positively associated with receiving occupational therapy services, but this relationship was moderated by age, minoritized status, significant other status, and insurance type. The findings provide direction for exploring determinants of disparities in occupational therapy utilization. What This Article Adds: Acute care occupational therapy utilization is driven partly by patient need, but potential disparities in access to beneficial services may exist across sociodemographic characteristics and insurance type. Identifying potential determinants of disparities in acute care occupational therapy utilization is the first step in developing strategies to reduce barriers for those in need.
日常生活活动（ADL）有困难的住院患者受益于职业治疗服务；然而，获得此类服务的差异研究不足。
调查需求（即 ADL 表现受限）是否预测急性护理职业治疗的利用，以及这种关系是否因社会人口因素和保险类型而异。
电子健康记录数据的二次分析。逻辑回归模型被指定用于确定 ADL 表现是否预测职业治疗治疗的使用。纳入交互项以调查 ADL 表现与职业治疗利用之间的关系是否因社会人口因素（例如年龄）和保险类型而异。
2014 年至 2018 年间，56022 名入住五家地区医院的成年人接受了职业治疗评估。
无。结局和测量：职业治疗服务的利用，活动措施后的护理“6-点击”日常活动的措施。
44%接受职业治疗评估的患者接受了治疗。ADL 表现较低的患者更有可能接受职业治疗治疗；然而，交互项表明，在 ADL 表现较低的患者中，年龄较小、为白人且非西班牙裔、有重要他人且有私人保险（而非公共保险）的患者更有可能接受治疗。在 ADL 表现较高的患者中，这些差异较小。
更大的需求与接受职业治疗服务呈正相关，但这种关系受到年龄、少数民族地位、重要他人地位和保险类型的调节。研究结果为探索职业治疗利用差异的决定因素提供了方向。这篇文章增加了什么：急性护理职业治疗的利用部分取决于患者的需求，但在社会人口特征和保险类型方面，获得有益服务的潜在差异可能存在。确定急性护理职业治疗利用差异的潜在决定因素是制定战略以减少有需要者障碍的第一步。
