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Prospective payment and the utilization of physical therapy service in the hospitalized elderly

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  • Holt, P.
  • Winograd, C.H.

Abstract

We studied the effect, in a university teaching hospital, of the prospective payment system (PPS) on utilization of physical therapy (PT), a non-reimbursable service; subjects were hospitalized patients aged 75 or older with non-PT-related diagnoses (myocardial infarction, pneumonia, congestive heart failure, and colectomy) and PT-related diagnoses (cerebrovascular accident and hip fracture). The proportion of patients referred for PT increased from 68 percent pre-PPS to 85 percent post-PPS for those with PT-related diagnoses and from 13 percent pre-PPS to 19 percent post-PPS for those with non-PT-related diagnoses. The mean number of sessions of PT decreased slightly for both groups: from 8.5 to 7.6 sessions for those with PT-related diagnoses and from 5.2 to 4.5 for those with non-PT-related diagnoses. In patients with PT-related diagnoses whose ambulatory status worsened during hospitalization, referrals for PT increased from 76 percent pre-PPS to 98 percent post-PPS. Referrals of comparable patients with non-PT-related diagnoses did not increase. Changes in provider education and efforts to reduce length of stay may account for these findings.

Suggested Citation

  • Holt, P. & Winograd, C.H., 1990. "Prospective payment and the utilization of physical therapy service in the hospitalized elderly," American Journal of Public Health, American Public Health Association, vol. 80(12), pages 1491-1494.
    • Handle: RePEc:aph:ajpbhl:1990:80:12:1491-1494_0
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