Association of Physical Therapy Treatment Frequency in the Acute Care Hospital With Improving Functional Status and Discharging Home.
Association of Physical Therapy Treatment Frequency in the Acute Care Hospital With Improving Functional Status and Discharging Home.
复制标题
急性护理医院物理治疗频率的关联，功能状况提高并出院。
DOI：
10.1097/mlr.0000000000001708
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发表时间：
2022-06-01
期刊：
影响因子：
3
通讯作者：
Freburger, Janet K.
中科院分区：
文献类型：
--
作者：
Johnson, Joshua K.;Rothberg, Michael B.;Adams, Kellie;Lapin, Brittany;Keeney, Tamra;Stilphen, Mary;Bethoux, Francois;Freburger, Janet K.
住院期间咨询物理治疗师（PT）以解决功能缺陷，但PT访视频率对患者结局的影响尚不清楚。检查PT访视频率是否与功能改善、出院回家以及两种结局的结合独立相关。回顾性队列研究。2017年至2020年期间，一个卫生系统的出院患者，按诊断亚组分层：心胸和血管，普通内科/外科，神经科，肿瘤科和骨科。PT访视频率分类为≤2次访视/周、>2-4次访视/周、>4-7次访视/周、>7次访视/周。功能改善定义为急性护理后活动测量活动性评分改善≥5分。其他结局为出院回家和两种结局合并。共纳入243，779例患者。频率类别内的比例范围为11.0%（>7次访视/周）至40.5%（≤2次访视/周），并因亚组而异。在全部样本中，36%的患者功能改善，64%出院回家，27%实现了两种结局。在校正分析中，相对于≤2次访视/周，功能改善的校正相对风险（aRR）随着频率的增加而递增（aRR=1.20，95%置信区间[CI]：1.14-1.26，>2-4次访视至aRR=1.78，95% CI：1.55-2.03，>7次访视）。对于所有患者和亚组内，更高的频率也与出院回家并实现这两种结果的可能性更大相关。住院期间更频繁的PT访视可能有助于功能改善和出院回家。然而，大多数患者很少接受访问。需要进一步研究，以确定PT服务的最佳提供，以满足个别病人的需求。
Physical therapists (PTs) are consulted to address functional deficits during hospitalization, but the effect of PT visit frequency on patients’ outcomes is not clear. To examine whether PT visit frequency is independently associated with functional improvement, discharge home, and both outcomes combined. Retrospective cohort study. Patients discharged from hospitals in one health system between 2017 and 2020, stratified by diagnostic subgroup: cardiothoracic and vascular, general medical/surgical, neurological, oncology, and orthopedic. PT visit frequency was categorized as ≤2 visits/week, >2–4 visits/week, >4–7 visits/week, >7 visits/week. Functional improvement was defined as ≥5-point improvement in Activity Measure for Post-Acute Care mobility score. Other outcomes were discharge home and both outcomes combined. There were 243,779 patients included. Proportions within frequency categories ranged from 11.0% (>7 visits/week) to 40.5% (≤2 visits/week) and varied by subgroup. In the full sample, 36% of patients improved function, 64% discharged home, and 27% achieved both outcomes. In adjusted analyses, relative to ≤2 visits/week, the adjusted relative risk (aRR) for functional improvement increased incrementally with higher frequency (aRR=1.20, 95% confidence interval [CI]: 1.14–1.26 for >2–4 visits to aRR=1.78, 95% CI: 1.55–2.03 for >7 visits). For all patients and within subgroups, higher frequency was also associated with greater likelihood of discharging home and achieving both outcomes. More frequent PT visits during hospitalization may facilitate functional improvement and discharge home. Most patients, however, receive infrequent visits. Further research is needed to determine the optimal delivery of PT services to meet individual patient needs.