Valenzuela-Moss Jacquelyn, Antoniak Katherine, Sarkisova Natalya, VandenBerg Curtis, Yang Joshua, Ryan Deirdre, Goldstein Rachel Y
Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Orthopedics Institute, Children's Hospital Colorado, Aurora, CO.
J Pediatr Soc North Am. 2024 Feb 5;5(4):649. doi: 10.55275/JPOSNA-2023-649. eCollection 2023 Nov.
Pediatric patients are often prescribed physical therapy following an orthopaedic diagnosis or surgical procedure; however, many children experience delays, which can consequently prolong recovery. The purpose of this study was to identify the factors that delay the patient's ability to receive timely care after referral to physical therapy (PT). Pediatric patients who were ordered physical therapy after orthopaedic treatment were prospectively recruited to participate in this study. Patients were administered a demographic questionnaire upon enrollment. Data collected included initial referral, date of authorization, and date of first PT appointment. A delay was defined as a wait of 2 weeks or more between the referral and first physical therapy appointment. Of 100 orthopaedic patients enrolled, 60% (60/100) had government insurance and 40% (40/100) had private insurance. Significant differences were revealed between insurance type (p=0.005), ethnicity (p=0.005), and site of injury (p=0.02) in time to first appointment. Patients with government insurance were 3.4 times more likely than patients with private insurance to experience a delay to physical therapy (95% CI: 1.5, 8.2). Only 27% (11/40) of patients with private insurance experienced a delay as compared to 57% (34/60) of patients with government insurance. Ten percent (6/60) of the patients with public insurance were never able to see a physical therapist while all privately insured patients were ultimately seen in PT. In multivariable analysis, Hispanic ethnicity and hip conditions were associated with delay in receiving PT. Patients with government insurance were over three times more likely to experience a delay in attending a physical therapy appointment than patients with private insurance, and 10% of patients with public insurance never saw a physical therapist. Insurance type may directly influence access to care or may be associated with demographic and socioeconomic factors decreasing the ability to utilize care. III •There is a delay in time to PT based on insurance type, ethnicity, and site of injury.•Patients with government insurance were over three times more likely to experience a delay in their initial physical therapy appointment than patients with private insurance.
儿科患者在接受骨科诊断或手术后通常会被安排物理治疗；然而，许多儿童会出现延迟，这可能会延长康复时间。本研究的目的是确定在转介至物理治疗（PT）后延迟患者获得及时治疗的能力的因素。前瞻性招募在骨科治疗后被安排物理治疗的儿科患者参与本研究。患者在入组时接受了一份人口统计学调查问卷。收集的数据包括初始转介、授权日期和首次物理治疗预约日期。延迟被定义为转介与首次物理治疗预约之间等待2周或更长时间。在入组的100名骨科患者中，60%（60/100）有政府保险，40%（40/100）有私人保险。在首次预约时间方面，保险类型（p = 0.005）、种族（p = 0.005）和受伤部位（p = 0.02）之间存在显著差异。有政府保险的患者接受物理治疗延迟的可能性是有私人保险患者的3.4倍（95%置信区间：1.5，8.2）。只有27%（11/40）有私人保险的患者出现延迟，而有政府保险的患者为57%（34/60）。10%（6/60）有公共保险的患者从未见过物理治疗师，而所有有私人保险的患者最终都接受了物理治疗。在多变量分析中，西班牙裔种族和髋部疾病与接受物理治疗的延迟有关。有政府保险的患者参加物理治疗预约延迟的可能性是有私人保险患者的三倍多，10%有公共保险的患者从未见过物理治疗师。保险类型可能直接影响获得医疗服务的机会，或者可能与降低利用医疗服务能力的人口统计学和社会经济因素相关。III•基于保险类型、种族和受伤部位，物理治疗时间存在延迟。•有政府保险的患者在首次物理治疗预约时延迟的可能性是有私人保险患者的三倍多。
