Highlights
- •Referral prioritization in home care occupational therapy is not standardized.
- •Priorities of elderly and disabled people are different from those of occupational therapists.
- •Home care occupational therapists prioritize people who fall.
- •Elderly and disabled people prioritize people who cannot enter and exit the home.
- •The target clientele should be consulted when establishing prioritization criteria.
Abstract
Objective
To compare the preferences of occupational therapists, elderly people, and adults
with disabilities regarding prioritization criteria for occupational therapy waiting
lists in home care.
Design
Discrete choice experiment survey.
Setting
Survey mailed to occupational therapists working in home care and community-dwelling
elderly or disabled persons.
Participants
A sample (N=714) of home-based occupational therapists (n=241), elderly persons from
a bank of research participants (n=226), and adults with physical disabilities recruited
through community organizations (n=247).
Interventions
Not applicable.
Main Outcome Measures
The dependent variable was whether the referral scenario was prioritized or not in
each question. The results were analyzed through logistic regression using conditional
logit models.
Results
Prioritization preferences differed between groups (P<.001). Occupational therapists most strongly prioritized people who had a few falls
(odds ratio vs no falls, 48.7), whereas elderly people and adults with disabilities
most strongly prioritized people who were unable to enter and exit the home (odds
ratio vs no difficulty entering and exiting the home, 30.8 for elderly people and
16.8 for persons with disabilities.)
Conclusions
Our results highlight the gap between the priorities of home-based occupational therapists
and their target clientele. Although further inquiry is needed to inform priority
setting, the findings emphasize the importance of public or patient involvement in
decisions on waiting list prioritization.
Keywords
List of abbreviations:
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Article info
Publication history
Published online: August 07, 2017
Footnotes
Supported by the Quebec Rehabilitation Research Network in partnership with the Office des personnes handicapées du Québec. Also supported by the Fonds de la recherche du Québec- Santé and the Greater Montreal Interdisciplinairy Rehabilitation Research Center. The funding bodies had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Disclosures: M.-H. Raymond was employed part-time as a home care occupational therapist, working mainly with elderly people. She is also a supporting member of Ex Aequo, an advocacy group for persons with physical disabilities. The other authors have nothing to disclose.
Identification
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© 2017 by the American Congress of Rehabilitation Medicine
