Abstract

There has been a significant increase in the utilization of home health care during the past decade. Medicare has attempted to control home care costs by 1) allowing Medicare beneficiaries to join Health Maintenance Organizations, and 2) requiring the use of the Outcome and Assessment Information Set (OASIS) for all patients admitted to home care services. These changes have challenged the home care physical therapist to be a better predictor of the total number of visits needed to complete the rehabilitation process. This was a retrospective study of 335 patients who received home health care physical therapy. The first part of this study determined the effects of admission activities of daily living (ADL) score, number of visits, level of comorbidity, payer class, and caregiver support on discharge ADL score. The second part of the study determined the effects of admission ADL score, level of comorbidity, payer class, and caregiver support on the total number of home care physical therapy visits. ADL scores were calculated using the Barthel Index. The level of comorbidity was calculated using the Charlson comorbidity index. Admission ADL score, number of visits, and level of comorbidity were the strongest predictors of discharge ADL score. Admission ADL score, while the strongest of the variables in the study, was a weak predictor of the number of visits. Although use of a prediction equation is not warranted by the data, the admission ADL score may provide the physical therapist with useful information when predicting the number of physical therapy visits needed. The Barthel Index is a useful tool to calculate the admission ADL score and can easily be calculated from the OASIS and physical therapy evaluation.

Key words: Barthel index, Comorbidity, Home health, Number of visits, Payer class

LLU Discipline

Physical Therapy

Department

Physical Therapy Sciences

School

School of Allied Health Professions

First Advisor

Grenith J. Zimmerman

Second Advisor

Dolores J. Wright

Third Advisor

Howard W. Sulzle

Degree Name

Doctor of Physical Therapy (DPT)

Degree Level

Ph.D.

Year Degree Awarded

2001

Date (Title Page)

6-2001

Language

English

Library of Congress/MESH Subject Headings

Physical Therapy -- statistics and numerical data; Outcome Assessment (Health Care); Program Evaluation; Reproducibility of Results; Recovery of Function; Cost Control; Health Maintenance Organizations; Medicare -- economics.

Type

Thesis

Page Count

vi; 33

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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