Higher Frequency of Acute Occupational Therapy Services Is Associated With Reduced Hospital Readmissions

2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Jessica Edelstein ◽  
Rebekah Walker ◽  
Addie Middleton ◽  
Timothy Reistetter ◽  
Kelli Williams Gary ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Patient Outcomes ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Self Care ◽  
Lower Odds ◽  
Therapy Services ◽  
Care Training ◽  
Therapy Service

Importance: Hospital readmissions are associated with poor patient outcomes, including higher risk for mortality, nutritional concerns, deconditioning, and higher costs. Objective: To evaluate how acute occupational therapy service delivery factors affect readmission risk. Design: Cross-sectional, retrospective study. Setting: Single academic medical center. Participants: Medicare inpatients with a diagnosis included in the Hospital Readmissions Reduction Program (HRRP; N = 17,618). Data were collected from medical records at a large urban hospital in southeastern Wisconsin. Outcomes and Measures: Logistic regression models were estimated to examine the association between acute occupational therapy service delivery factors and odds of readmission. In addition, the types of acute occupational therapy services for readmitted versus not-readmitted patients were compared. Results: Patients had significantly higher odds of readmission if they received occupational therapy services while hospitalized (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.07, 1.31]). However, patshients who received acute occupational therapy services had significantly lower odds of readmission if they received a higher frequency (OR = 0.99, 95% CI [0.99,1.00]) of acute occupational therapy services. A significantly higher proportion of patients who were not readmitted, compared with patients who were readmitted, received activities of daily living (ADL) or self-care training (p < .01). Conclusions and Relevance: For patients with HRRP-qualifying diagnoses who received acute occupational therapy services, higher frequency of acute occupational therapy services was linked with lower odds of readmission. Readmitted patients were less likely to have received ADL or self-care training while hospitalized. What This Article Adds: Identifying factors of acute occupational therapy services that reduce the odds of readmission for Medicare patients may help to improve patient outcomes and further define occupational therapy’s role in the U.S. quality-focused health care system.

scholarly journals Telehealth for the Provision of Occupational Therapy: Reflections on Experiences During the COVID-19 Pandemic

2020 ◽  
Vol 12 (2) ◽  
pp. 77-92
Author(s):  
Sue Dahl-Popolizio ◽  
Heidi Carpenter ◽  
Melissa Coronado ◽  
Nicholas J. Popolizio ◽  
Connor Swanson
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Service Delivery Model ◽  
Cross Sectional ◽  
Delivery Model ◽  
Therapy Services ◽  
Effective Service ◽  
Therapy Service

During the COVID-19 pandemic of 2020, healthcare professionals worldwide abruptly shifted from an in-person to a telehealth service delivery model. Many did so without advanced training or preparation. This cross-sectional study explored how occupational therapy practitioners (OTPs) used telehealth during the COVID-19 pandemic, and whether they found it to be an effective service delivery model that should be a permanent option for providing occupational therapy services. An online survey was disseminated; it included Likert scale questions, multiple option questions, and open-ended questions regarding telehealth use during the COVID-19 pandemic. Of the 230 respondents, 176 (77%) support telehealth as a substitute for in-person services; 179 (78%) support telehealth as a permanent option for occupational therapy service delivery. This information lends support to the uninterrupted use of telehealth by OTPs when government emergency orders in response to COVID-19 expire.

Impact of Acute Self-Care Indicators and Social Factors on Medicare Inpatient Readmission Risk

2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Jessica Edelstein ◽  
Addie Middleton ◽  
Rebekah Walker ◽  
Timothy Reistetter ◽  
Stacey Reynolds
Keyword(s):  
Social Support ◽  
Occupational Therapy ◽  
Acute Care ◽  
Social Factors ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Self Care ◽  
Housing Situation ◽  
Cross Sectional

Importance: Readmissions are costly for Medicare and are associated with poor patient outcomes. Objective: To determine whether two domains relevant to acute occupational therapy practice—self-care status and social factors—were associated with readmissions for Medicare patients in the Medicare Hospital Readmissions Reduction Program (HRRP). Design: Cross-sectional, retrospective study. Setting: Single academic medical center. Participants: Medicare inpatients with a diagnosis included in the HRRP (N = 17,618). Outcomes and Measures: Three logistic regression models were estimated to examine the associations among (1) self-care status and 30-day readmission, (2) social support and 30-day readmission, and (3) housing situation and 30-day readmission. Subgroup analyses were conducted for the individual HRRP diagnoses. Results: No associations were found between acute self-care status, social support, or housing situation and 30-day readmission when all HRRP diagnoses were examined together. However, higher levels of independence with self-care were significantly associated with reduced odds of readmission for patients with pneumonia. Conclusions and Relevance: The findings for patients with pneumonia are consistent with those of other studies done in the acute care setting. Deficiencies in acute occupational therapy documentation may have affected the findings for the other HRRP diagnoses. What This Article Adds: This study is the first to examine the association between acute self-care status (as documented by acute care occupational therapy practitioners) and readmission.

scholarly journals Occupational Therapy Service Delivery Among Medicaid-Enrolled Children and Adults on the Autism Spectrum and With Other Intellectual Disabilities

2022 ◽  
Vol 76 (1) ◽  
Author(s):  
Teal W. Benevides ◽  
Sha Tao ◽  
Alec Becker ◽  
Kate Verstreate ◽  
Lindsay Shea
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Service Utilization ◽  
Service Use ◽  
Autism Spectrum ◽  
Structural Factors ◽  
Coding System ◽  
Retrospective Case ◽  
Therapy Services ◽  
Therapy Service

Abstract Importance: Rates of occupational therapy service utilization among people with autism spectrum disorder (ASD) or intellectual disability (ID) have not been explored in population-based samples. Objective: To describe occupational therapy services delivered to Medicaid-eligible persons younger than age 65 yr identified as having ASD, ID, or both and to evaluate demographic factors associated with occupational therapy service utilization in this population. Design: Retrospective, case–control, cohort study using claims records from Medicaid Analytic eXtract files (2009–2012). Setting: Data from all 50 states and Washington, DC. Participants: Beneficiaries identified as having ASD only, ASD+ID, or ID only who were younger than age 18 yr (N = 664,214) and ages 18–64 yr (N = 702,338). Outcomes and Measures: We analyzed Current Procedural Terminology® and Healthcare Common Procedure Coding System procedure codes, Medicaid Statistical Information System type of service codes, and Center for Medicare & Medicaid Services provider specialty codes. Results: Only 3.7% to 6.3% of eligible adult beneficiaries received occupational therapy; in contrast, 20.5% to 24.2% of children received occupational therapy. Significant predictors of service use varied by group; however, differences by race–ethnicity, eligibility on the basis of poverty, and geographic location were observed. Among children, the most frequent billing code was for “therapeutic activities” (43%–60%); among adults, it was “community/work reintegration training” (29%–39%). Conclusions and Relevance: Billed procedure code patterns do not consistently reflect the unique occupational focus that occupational therapy providers deliver to people with developmental disabilities. Disparities in occupational therapy receipt warrant further attention to understand the social and structural factors affecting service delivery. What This Article Adds: Occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses. Greater understanding of the intersectional factors that drive service delivery and disparities is needed.

scholarly journals Barriers of Occupation-based Intervention

2016 ◽  
Vol 1 (4) ◽  
pp. 1
Author(s):  
Ahmad Zamir Che Daud ◽  
Jenni Judd ◽  
Matthew Yau ◽  
Fiona Barnett
Keyword(s):  
Clinical Practice ◽  
Open Access ◽  
Occupational Therapy ◽  
Service Delivery ◽  
Delphi Study ◽  
Publishing House ◽  
Delphi Round ◽  
International Publishing ◽  
Open Access Article ◽  
Therapy Service

A Delphi study with three rounds of inquiry was conducted to identify the barriers of implementing Occupation-based Intervention (OBI) in Malaysia. Fifteen occupational therapy practitioners and educators consented and completed all the Delphi rounds. The first Delphi round began with an open-ended questionnaire asking the participants a broad question on barriers for applying OBI into clinical practice. Data was qualitatively analysed to develop statements about the barriers of applying OBI were grouped under five categories. In the second and third round, the participants were asked to rank their agreement with the statements about the barriers in applying OBI. Twenty-seven statements finally achieved the consensus level.2398-4279 © 2016. The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK.. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.Keywords: Occupation, Clinical Practice, Occupational Therapy, Service Delivery

The Role of the Pediatrician in Prescribing Therapy Services for Children With Motor Disabilities

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 308-310 ◽  
Author(s):  
Keyword(s):  
Occupational Therapy ◽  
Motor Disabilities ◽  
Therapy Services ◽  
Therapy Service

Pediatricians are often called upon to prescribe physical and occupational therapy service for children with motor disabilities. This statement defines the context in which rehabilitation therapies should be prescribed, emphasizing the identification and enhancement of the child's function and abilities. The statement encourages the pediatrician to work with teams including the parents, child, teachers, therapists, and other physicians.

scholarly journals Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from Ireland

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Carol O’Donoghue ◽  
Jennifer O’Leary ◽  
Helen Lynch
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Service Provision ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Evidence Based ◽  
Snowball Sampling ◽  
Cross Sectional ◽  
School Based ◽  
Therapy Services

Purpose. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods. This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results. The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.

scholarly journals Barriers of Occupation-based Intervention

2016 ◽  
Vol 1 (4) ◽  
pp. 1
Author(s):  
Ahmad Zamir Che Daud ◽  
Jenni Judd ◽  
Matthew Yau ◽  
Fiona Barnett
Keyword(s):  
Clinical Practice ◽  
Open Access ◽  
Occupational Therapy ◽  
Service Delivery ◽  
Delphi Study ◽  
Publishing House ◽  
Delphi Round ◽  
International Publishing ◽  
Open Access Article ◽  
Therapy Service

A Delphi study with three rounds of inquiry was conducted to identify the barriers of implementing Occupation-based Intervention (OBI) in Malaysia. Fifteen occupational therapy practitioners and educators consented and completed all the Delphi rounds. The first Delphi round began with an open-ended questionnaire asking the participants a broad question on barriers for applying OBI into clinical practice. Data was qualitatively analysed to develop statements about the barriers of applying OBI were grouped under five categories. In the second and third round, the participants were asked to rank their agreement with the statements about the barriers in applying OBI. Twenty-seven statements finally achieved the consensus level.2398-4279 © 2016. The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK.. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.Keywords: Occupation, Clinical Practice, Occupational Therapy, Service Delivery

Quality of Local Authority Occupational Therapy Services: Developing an Instrument to Measure the User's Perspective

2000 ◽  
Vol 63 (4) ◽  
pp. 155-162 ◽  
Author(s):  
Siân Calnan ◽  
Herman J Sixma ◽  
Michael W Calnan ◽  
Peter P Groenewegen
Keyword(s):  
Quality Of Care ◽  
Occupational Therapy ◽  
Quantitative Methods ◽  
Local Authority ◽  
General Process ◽  
Health And Social Care ◽  
New Instrument ◽  
Therapy Services ◽  
Therapy Service

The aims of this paper are threefold: (1) to describe the development of an instrument measuring quality of care from the specific perspective of the users of local authority occupational therapy services; (2) to present the results from a survey of users' views about the quality of services offered by a county-wide local authority occupational therapy service compared with other health and social care services; and (3) to examine the potential of the instrument to form part of a more general process of quality assurance and quality improvement within local authority occupational therapy services. A combination of qualitative and quantitative methods was used. Focus group discussions with users preceded a postal survey. Questionnaires were sent to a random sample of 997 disabled people living in Kent who were users of the local authority Occupational Therapy Bureau. The response rate was 55%. An instrument was developed (QUOTE-OT) which was tailored to the expressed needs of the users of a local authority occupational therapy service (Kent Occupational Therapy Bureau). On the basis of this new instrument, the Kent Occupational Therapy Bureau received relatively high performance scores on the quality of care dimensions that were the most important for users, such as aspects that referred to courtesy and the level of professional competence. On the other hand, room for improvement existed on aspects such as the accessibility of occupational therapy services, information given to users and follow-up services. The evidence suggests that the QUOTE-OT questionnaire for assessing users' views of quality of care could be an appropriate tool for evaluating and monitoring local authority occupational therapy service quality.

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