HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Holt, P Articles by Winograd, C H Search for Related Content PubMed PubMed Citation Articles by Holt, P Articles by Winograd, C H

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

P Holt and C H Winograd

St. Luke's Hospital, Kansas City Missouri.

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.