Mobility Status and Acute Care Physical Therapy Utilization: The Moderating Roles of Age, Significant Others, and Insurance Type

Objective: To investigate whether a direct measure of need for physical therapy (PT), mobility status, was associated with acute care PT utilization and whether this relationship differs across sociodemographic factors and insurance type. Design: In a secondary analysis of electronic health records data, we estimated logistic regression models to determine whether mobility status was associated with acute care PT utilization. Interactions between mobility and both sociodemographic factors (sex, age, significant other, minority status) and insurance type were included to investigate whether the relationship between mobility and PT utilization varied across patient characteristics. Setting: Five regional hospitals from 1 health system. Participants: A total of 60,459 adults admitted between 2014 and 2018 who received a PT evaluation. Interventions: None. Main Outcome Measures: Received acute care PT; Activity Measure for Post-Acute Care “6-Clicks” measure of mobility. Results: Half of patients who received a PT evaluation received subsequent treatment. Patients with mobility limitations were more likely to receive PT. Interaction terms indicated that among patients with mobility limitations, those who (1) were younger, (2) had significant others, and (3) had private insurance (vs public) were more likely to receive PT. Among patients with greater mobility status, older patients and those without a significant other were more likely to receive PT. Conclusions: The relationship between acute care PT need and utilization differed across sociodemographic factors and insurance type. We offer potential explanations for these findings to guide efforts targeting equitable distribution of beneficial PT services.