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An Analysis of the Relationship Between the Utilization of Physical Therapy Services and Outcomes of Care for Patients After Total Hip Arthroplasty

JK Freburger, PT, PhD, is Assistant Professor, Division of Physical Therapy, University of North Carolina at Chapel Hill, CB 7135, Medical School Wing E, Chapel Hill, NC 27599-7135 (USA) (jfreburger{at}css.unc.edu)

Background and Purpose. The effect of physical therapy intervention on the outcomes of care for patients treated in acute care hospitals has not been widely studied. This study examined the relationship between physical therapy utilization and outcomes of care for patients following total hip arthroplasty. Subjects. The sample consisted of 7,495 patients treated in US academic health center hospitals in 1996 who survived their inpatient stay and received physical therapy interventions. Methods. The primary data source was the University HealthSystem Consortium Clinical Data Base. Physical therapy use was assessed by examining physical therapy charges. Outcomes of care were assessed in terms of the total cost of care (ie, whether the care was more costly or less costly than expected, taking into account patient characteristics) and in terms of discharge destination (ie, whether the patient was discharged home or elsewhere). Regression analyses were conducted to examine the relationship between physical therapy use and outcomes. Results. Physical therapy intervention was directly related to a total cost of care that was less than expected and to an increased probability of discharge home. Conclusion and Discussion. The results of this study provide preliminary evidence to support the use of physical therapy intervention in the acute care of patients following total hip arthroplasty and indicate the need for further study of this topic.

Key Words: Health services research • Outcomes • Total hip arthroplasty

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