Abstract
Objective
To characterize rehabilitation service use among community-dwelling older adults in
the United States by identifying predictors of rehabilitation utilization, patient-reported
functional improvement, and rehabilitation goal attainment.
Design
Cross-sectional analysis of the 2015 National Health and Aging Trends Study, which
used an age-stratified, multistage sampling design and oversampled blacks and the
oldest old (≥85y).
Setting
Standardized, in-person home interviews and physical performance testing.
Participants
Nationally representative sample of community-dwelling Medicare beneficiaries (N=7487)
aged ≥65 years.
Interventions
Not applicable.
Main Outcome Measures
Rehabilitation services use (physical therapy, occupational therapy, and speech therapy)
across all settings in the last year, patient-reported functional improvement, and
patient-reported rehabilitation goal attainment.
Results
Twenty percent of older adults reported rehabilitation use in the last year. In a
multivariable model, rehabilitation use was significantly lower among blacks and higher
among those with higher education, chronic medical conditions, pain, history of falls,
and severe limitations in physical performance. Overall, 72% reported functional improvement
during rehabilitation, and 75% reported meeting their goals by discharge. Improved
function was associated with longer duration of rehabilitation. A significantly lower
percentage of older adults with bothersome pain and severe physical limitations reported
meeting rehabilitation goals.
Conclusions
Most older adults who received rehabilitation reported functional improvement and
meeting rehabilitation goals. However, social disparities were evident with lower
rehabilitation utilization among blacks and those with less education. Importantly,
functional improvement and goal attainment did not vary by demographics or diagnoses.
Longer duration of rehabilitation and improved pain management may be necessary for
functional improvement and goal attainment.
Keywords
List of abbreviations:
ADL (activities of daily living), CI (confidence interval), NHATS (National Health and Aging Trends Study), SPPB (Short Physical Performance Battery)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 03, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
