Kinney Adam R, Penzenik Molly E, Forster Jeri E, O'Donnell Frederica, Fox Valerie, Brenner Lisa A
Adam R. Kinney, PhD, OTR/L, is Research Health Science Specialist, Veteran Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora;
Molly E. Penzenik, MPH, is Data Analyst, Veteran Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, and Data Analyst, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora.
Am J Occup Ther. 2025 Jul 1;79(4). doi: 10.5014/ajot.2025.051064.
Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated.
To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics.
Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics.
VHA outpatient setting.
Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived ≥90 days after discharge (N = 117,679).
None.
Outpatient occupational therapy utilization ≤90 days of inpatient psychiatric discharge.
Only 13% of Veterans received outpatient occupational therapy services after discharge, and ADL limitations were not associated with receipt of occupational therapy. Veterans receiving care in facilities of lower complexity and those with greater care quality were more likely to receive occupational therapy. Black and Hispanic Veterans were less likely to receive occupational therapy.
Our findings suggest potentially unmet need for outpatient occupational therapy among Veterans discharged from VHA inpatient psychiatric care, laying the foundation for efforts aimed at promoting equitable access. Plain-Language Summary: This is the first study to examine potential disparities in access to outpatient occupational therapy services among Veterans recently discharged from Veterans Health Administration inpatient psychiatric care. The findings suggest a potentially unmet need for these beneficial services in this population. This study lays the foundation for scientific, clinical, and policy efforts aimed at promoting equitable access to outpatient occupational therapy services among Veterans in need, ensuring successful occupational performance and overall well-being among all members of this high-risk population.
接受住院精神科护理且存在职业表现（如日常生活活动 [ADL]）受限的退伍军人出院后可能会从门诊职业治疗中受益，但尚未对获取差异进行调查。
调查ADL受限这一需求指标是否与退伍军人健康管理局（VHA）住院精神科住院后门诊职业治疗的利用情况相关，以及这种关系是否因机构特征而异。
对VHA病历数据进行二次分析。采用修正泊松回归模型，将门诊职业治疗的利用情况（是或否）作为ADL受限、机构特征以及社会人口学和临床特征的函数。通过交互作用来估计ADL受限与门诊职业治疗利用情况之间的关系在不同机构特征中是否存在差异。
VHA门诊环境。
2015年至2020年接受VHA住院精神科护理且出院后存活≥90天的退伍军人（N = 117,679）。
无。
住院精神科出院后≤90天的门诊职业治疗利用情况。
只有13%的退伍军人出院后接受了门诊职业治疗服务，且ADL受限与接受职业治疗无关。在复杂性较低和护理质量较高的机构接受护理的退伍军人更有可能接受职业治疗。黑人和西班牙裔退伍军人接受职业治疗的可能性较小。
我们的研究结果表明，从VHA住院精神科护理出院的退伍军人中，门诊职业治疗的需求可能未得到满足，这为旨在促进公平获取的努力奠定了基础。
这是第一项研究退伍军人健康管理局住院精神科护理近期出院的退伍军人在获取门诊职业治疗服务方面潜在差异的研究。研究结果表明，这一人群对这些有益服务的需求可能未得到满足。本研究为旨在促进有需要的退伍军人公平获取门诊职业治疗服务的科学、临床和政策努力奠定了基础，确保这一高危人群的所有成员都能成功实现职业表现并保持总体健康。
