TY - JOUR
T1 - Outpatient Physical Therapy Use Following Tibial Fractures
T2 - A Retrospective Commercial Claims Analysis
AU - McLaughlin, Kevin H.
AU - Reider, Lisa M.
AU - Castillo, Renan C.
AU - Ficke, James R.
AU - Levy, Joseph F.
N1 - Funding Information:
Funding was provided by the US Department of Health and Human Services, National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32 AR067708), and the Major Extremity Trauma Rehabilitation Consortium through the US Department of Defense (W81XWH-16-2-0060).
Publisher Copyright:
© 2021 Oxford University Press. All rights reserved.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Objective. The purpose of this study was to characterize outpatient physical therapy (OPT) use following tibial fractures and examine the variability of OPT attendance, time of initiation, number of visits, and length of care by patient, injury, and treatment factors. In the absence of clinical guidelines, results will guide future efforts to optimize OPT following tibial fractures. Methods. This study used 2016 to 2017 claims from the IBM MarketScan Commercial Claims Research Database. The cohort included 9079 patients with International Classification of Diseases: Tenth Revision (ICD-10) diagnosis codes for tibial fractures. Use in the year following initial fracturemanagement was determined using Current Procedural Terminology codes. Differences in use were examined using ?2 tests, t tests, and Kruskal-Wallace tests. Results. Sixty-seven percent of patients received OPT the year following fracture. OPT attendance was higher in female patients, in patients with 1 or no major comorbidity, and in the western United States. Attendance was higher in patients with upper tibial fractures, moderate-severity injuries, and treatment with external fixation and in patients discharged to an inpatient rehabilitation facility. Patients started OPT on average [SD] 50 [52.6] days after fracture and attended 18 [16.1] visits over the course of 101 [86.4] days. The timing of OPT, the number of visits attended, and the length of OPT care varied by patient, injury, and treatment-level factors. Conclusions. One-third of insured patients do not receive OPT following tibial fracture. The timing of OPT initiation, the length of OPT care, and the number of visits attended by patients with tibial fractures were highly variable. Further research is needed to standardize referral and prescription practices for OPT following tibial fractures. Impact. OPT use varies based on patient, injury, and treatment-level factors following tibial fractures. Results from this study can be used to inform future efforts to optimize rehabilitation care for patients with tibial fractures.
AB - Objective. The purpose of this study was to characterize outpatient physical therapy (OPT) use following tibial fractures and examine the variability of OPT attendance, time of initiation, number of visits, and length of care by patient, injury, and treatment factors. In the absence of clinical guidelines, results will guide future efforts to optimize OPT following tibial fractures. Methods. This study used 2016 to 2017 claims from the IBM MarketScan Commercial Claims Research Database. The cohort included 9079 patients with International Classification of Diseases: Tenth Revision (ICD-10) diagnosis codes for tibial fractures. Use in the year following initial fracturemanagement was determined using Current Procedural Terminology codes. Differences in use were examined using ?2 tests, t tests, and Kruskal-Wallace tests. Results. Sixty-seven percent of patients received OPT the year following fracture. OPT attendance was higher in female patients, in patients with 1 or no major comorbidity, and in the western United States. Attendance was higher in patients with upper tibial fractures, moderate-severity injuries, and treatment with external fixation and in patients discharged to an inpatient rehabilitation facility. Patients started OPT on average [SD] 50 [52.6] days after fracture and attended 18 [16.1] visits over the course of 101 [86.4] days. The timing of OPT, the number of visits attended, and the length of OPT care varied by patient, injury, and treatment-level factors. Conclusions. One-third of insured patients do not receive OPT following tibial fracture. The timing of OPT initiation, the length of OPT care, and the number of visits attended by patients with tibial fractures were highly variable. Further research is needed to standardize referral and prescription practices for OPT following tibial fractures. Impact. OPT use varies based on patient, injury, and treatment-level factors following tibial fractures. Results from this study can be used to inform future efforts to optimize rehabilitation care for patients with tibial fractures.
KW - Claims Analysis
KW - Fractures
KW - Orthopedics
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85107091380&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107091380&partnerID=8YFLogxK
U2 - 10.1093/ptj/pzab034
DO - 10.1093/ptj/pzab034
M3 - Article
C2 - 33522593
AN - SCOPUS:85107091380
VL - 101
JO - Physical Therapy
JF - Physical Therapy
SN - 0031-9023
IS - 5
M1 - pzab034
ER -