Kristal Anat, Gaunaurd Ignacio A, Morgan Sara J, Balkman Geoffrey S, Rosen Rachael E, Salem Rana, Bamer Alyssa M, Hafner Brian J
Department of Physical Therapy, University of Miami Miller School of Medicine, Florida, United States of America.
Department of Rehabilitation Medicine, University of Washington School of Medicine, Washington, United States of America.
PLoS One. 2025 Aug 20;20(8):e0330528. doi: 10.1371/journal.pone.0330528. eCollection 2025.
As value-based care becomes increasingly central to healthcare delivery in the United States, physical therapists (PTs) are expected to use outcome measures (OMs) to demonstrate meaningful improvements in patient health. Although OMs play a critical role in supporting value-based practice, prior research suggests they are not routinely used, and limited attention has been given to how resource availability may influence their implementation, particularly for performance-based tests. This study aimed to assess PTs' use of OMs, including their perceptions of value, motivations for use, and the resources available for administration. An online survey was used to evaluate outcomes measurement practices of PTs in the United States. Invitations were mailed to a random sample of American Physical Therapy Association members. Frequencies and percentages were calculated. Nearly all respondents (n = 514) used OMs with their patients, but performance-based tests were used more than self-report surveys (97% and 83%, respectively). Most respondents agreed that OMs were within their scope of practice (>95%) and could be administered with knowledge they possessed (>88%). However, less than 50% agreed OMs are administered in a standardized manner across the profession. Most respondents (89%) indicated that performance-based tests "help me make clinical decisions," but fewer (61%) said the same about self-report surveys. Respondents were also willing to dedicate more time to performance-based tests than self-report surveys (up to 20 and 10 minutes, respectively). Most respondents (>80%) indicated they had smaller rooms and short hallways (≤10m) for OM administration. Results of this study indicate PTs in the United States have the knowledge, time, and space to administer many of the OMs recommended for use in physical therapy. While PTs use both types of OMs, performance-based tests are often perceived to have greater clinical value. Obtaining consensus on specific protocols for administering OMs may help to address concerns about the lack of standardization across the profession.
随着基于价值的医疗在美国医疗服务中变得越来越核心，物理治疗师（PTs）被期望使用结果测量指标（OMs）来证明患者健康状况有意义的改善。尽管结果测量指标在支持基于价值的实践中起着关键作用，但先前的研究表明它们并未被常规使用，并且对于资源可用性如何影响其实施，尤其是基于表现的测试，关注有限。本研究旨在评估物理治疗师对结果测量指标的使用情况，包括他们对价值的看法、使用动机以及可用于实施的资源。一项在线调查被用于评估美国物理治疗师的结果测量实践。邀请信被邮寄给美国物理治疗协会成员的随机样本。计算了频率和百分比。几乎所有受访者（n = 514）都在其患者中使用了结果测量指标，但基于表现的测试比自我报告调查使用得更多（分别为97%和83%）。大多数受访者同意结果测量指标在其执业范围内（>95%），并且可以凭借他们所拥有的知识进行实施（>88%）。然而，不到50%的受访者同意结果测量指标在整个行业以标准化方式进行实施。大多数受访者（89%）表示基于表现的测试“帮助我做出临床决策”，但较少（61%）的人对自我报告调查也这样认为。受访者也愿意为基于表现的测试投入比自我报告调查更多的时间（分别高达20分钟和10分钟）。大多数受访者（>80%）表示他们用于实施结果测量指标的房间较小且走廊较短（≤10米）。本研究结果表明，美国的物理治疗师具备实施许多推荐用于物理治疗的结果测量指标的知识、时间和空间。虽然物理治疗师使用这两种类型的结果测量指标，但基于表现的测试通常被认为具有更大的临床价值。就实施结果测量指标的具体方案达成共识可能有助于解决对整个行业缺乏标准化的担忧。
