Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge
Objective: To investigate whether the relationships between acute care occupational therapy (OT) and physical therapy (PT) utilization and community discharge are moderated by functional or physical performance at discharge among individuals hospitalized with traumatic brain injury (TBI). Setting: 1...
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| Language: | English |
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MDPI AG
2024-09-01
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| Series: | Trauma Care |
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| Online Access: | https://www.mdpi.com/2673-866X/4/4/22 |
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| author | Rayyan A. Bukhari Jennifer A. Weaver Julia Sharp Amanda Hoffman Deana Davalos Matt P. Malcolm James E. Graham |
| author_facet | Rayyan A. Bukhari Jennifer A. Weaver Julia Sharp Amanda Hoffman Deana Davalos Matt P. Malcolm James E. Graham |
| author_sort | Rayyan A. Bukhari |
| collection | DOAJ |
| description | Objective: To investigate whether the relationships between acute care occupational therapy (OT) and physical therapy (PT) utilization and community discharge are moderated by functional or physical performance at discharge among individuals hospitalized with traumatic brain injury (TBI). Setting: 14 acute care hospitals in the state of Colorado. Participants: We studied 5599 adults hospitalized with TBI between June 2018 and April 2021. Design: In a secondary analysis of de-identified electronic health record (EHR) data, multivariable moderation logistic regression models were performed to calculate odds ratios (ORs) for the likelihood of community discharge among patients who utilized OT/PT services. Main Measures: Functional (activities of daily living [ADL]) and physical (mobility) performance at discharge, OT and PT utilization, and community discharge status. Results: Overall, 67% of patients discharged to the community. The mean age of the sample was 55 years (SD = 20 years). Most participants were male (64%) and non-Hispanic White (72%). Mean hospital length of stay was 6 days (SD = 6 days). Both OT and PT utilization (OT: OR = 1.21, 95% CI [1.11, 1.33]; PT: OR = 1.22, 95% CI [1.14, 1.30]) and discharge ADL and mobility scores (ADL: OR = 1.34, 95% CI [1.30, 1.39]; mobility: OR = 1.38, 95% CI [1.33, 1.42]) were significantly and positively associated with community discharge. The OT and PT utilization-by-discharge ADL and mobility interaction terms yielded slightly negative, but statistically significant moderation effects in both models (ORs = 0.99, 95% CIs [0.98, 1.00]); indicating the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. Several sociodemographic characteristics and clinical factors were also independently associated with community discharge in both models (<i>p</i>-values < 0.001–0.04). Conclusions: Greater OT and PT utilization was associated with increased odds of community discharge. Similarly, higher ADL and mobility scores at discharge were associated with increased odds of community discharge. The small, but statistically significant negative interaction terms in both models indicated that the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. This study’s findings can guide occupational and physical therapists in their efforts to facilitate a safe transition to the community for patients with TBI. |
| format | Article |
| id | doaj-art-f490b87383d446e5952ca69408cc55c3 |
| institution | Kabale University |
| issn | 2673-866X |
| language | English |
| publishDate | 2024-09-01 |
| publisher | MDPI AG |
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| series | Trauma Care |
| spelling | doaj-art-f490b87383d446e5952ca69408cc55c32024-12-27T14:57:05ZengMDPI AGTrauma Care2673-866X2024-09-014424926510.3390/traumacare4040022Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at DischargeRayyan A. Bukhari0Jennifer A. Weaver1Julia Sharp2Amanda Hoffman3Deana Davalos4Matt P. Malcolm5James E. Graham6Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USADepartment of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USASharp Analytics, LLC, Fort Collins, CO 80524, USADepartment of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USADepartment of Psychology, Colorado State University, Fort Collins, CO 80521, USADepartment of Occupational Therapy, Rocky Mountain University of Health Professions, Provo, UT 84606, USADepartment of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USAObjective: To investigate whether the relationships between acute care occupational therapy (OT) and physical therapy (PT) utilization and community discharge are moderated by functional or physical performance at discharge among individuals hospitalized with traumatic brain injury (TBI). Setting: 14 acute care hospitals in the state of Colorado. Participants: We studied 5599 adults hospitalized with TBI between June 2018 and April 2021. Design: In a secondary analysis of de-identified electronic health record (EHR) data, multivariable moderation logistic regression models were performed to calculate odds ratios (ORs) for the likelihood of community discharge among patients who utilized OT/PT services. Main Measures: Functional (activities of daily living [ADL]) and physical (mobility) performance at discharge, OT and PT utilization, and community discharge status. Results: Overall, 67% of patients discharged to the community. The mean age of the sample was 55 years (SD = 20 years). Most participants were male (64%) and non-Hispanic White (72%). Mean hospital length of stay was 6 days (SD = 6 days). Both OT and PT utilization (OT: OR = 1.21, 95% CI [1.11, 1.33]; PT: OR = 1.22, 95% CI [1.14, 1.30]) and discharge ADL and mobility scores (ADL: OR = 1.34, 95% CI [1.30, 1.39]; mobility: OR = 1.38, 95% CI [1.33, 1.42]) were significantly and positively associated with community discharge. The OT and PT utilization-by-discharge ADL and mobility interaction terms yielded slightly negative, but statistically significant moderation effects in both models (ORs = 0.99, 95% CIs [0.98, 1.00]); indicating the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. Several sociodemographic characteristics and clinical factors were also independently associated with community discharge in both models (<i>p</i>-values < 0.001–0.04). Conclusions: Greater OT and PT utilization was associated with increased odds of community discharge. Similarly, higher ADL and mobility scores at discharge were associated with increased odds of community discharge. The small, but statistically significant negative interaction terms in both models indicated that the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. This study’s findings can guide occupational and physical therapists in their efforts to facilitate a safe transition to the community for patients with TBI.https://www.mdpi.com/2673-866X/4/4/22community dischargehealth services researchoccupational therapyphysical therapyfunctional and physical performancetraumatic brain injury |
| spellingShingle | Rayyan A. Bukhari Jennifer A. Weaver Julia Sharp Amanda Hoffman Deana Davalos Matt P. Malcolm James E. Graham Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge Trauma Care community discharge health services research occupational therapy physical therapy functional and physical performance traumatic brain injury |
| title | Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge |
| title_full | Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge |
| title_fullStr | Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge |
| title_full_unstemmed | Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge |
| title_short | Acute Care Rehabilitation Services Utilization and Post-Acute Discharge Destination among Adults with Traumatic Brain Injury: The Moderating Effect of Functional and Physical Performance at Discharge |
| title_sort | acute care rehabilitation services utilization and post acute discharge destination among adults with traumatic brain injury the moderating effect of functional and physical performance at discharge |
| topic | community discharge health services research occupational therapy physical therapy functional and physical performance traumatic brain injury |
| url | https://www.mdpi.com/2673-866X/4/4/22 |
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