Home health physical therapy sessions — set for major changes under the upcoming Patient-Driven Groupings Model (PDGM) — can drastically lower the risk of re-hospitalization among older adults following discharge.
That’s according to a new study published earlier this month in Journal of the American Medical Directors Association. Specifically, the study found, one to two weekly physical therapy sessions can help lower the chances of re-hospitalization among older adults by up to 82% in a 60-day period.
In the U.S., more than 3.3 million re-hospitalizations take place annually, and one-third of Medicare patients experience functional decline within 90 days of being released from the hospital.
Unlike similar efforts, the recently published study is noteworthy because it looks at the specific amount of home health care therapy services that are effective in preventing re-hospitalization, in particular, whereas previous research focused on how services can improve physical function and reduce health care costs.
“Every patient’s situation is different,” Jinjiao Wang, lead author and an assistant professor from the University of Rochester School of Nursing, told Home Health Care News. “Instead of giving everybody the same amount of service — or the maximum amount of service possible — what might be more effective is to do a very precise assessment of the patient in the beginning, and use that information to direct not just the type of service, but the amount of service.”
As part of the study, researchers analyzed OASIS data and Medicare-certified home health care administrative records from one statewide nonprofit home health agency to determine the impact of programs such as physical therapy, skilled nursing and occupational therapy on re-hospitalization among older patients.
The analysis utilized a sample size of more than 1,300 patients who were 65 or older and admitted into a home health program within 48 hours of being released from the hospital. Within that sample, 11.5% of the patients saw re-hospitalization within the 60-day period.
In addition to lowering the risk or re-hospitalization by 82% after receiving physical therapy services, risk was likewise lowered by 48% with two weekly skilled nursing visits.
“With the new reimbursement policy from CMS that is going to occur in the near future, the amount of [therapy] service one can receive will be even more restricted,” Wang said. “I think that instead of just limiting the amount of service for patients, a more sensible approach to improve the outcome of home health care services in the United States, specifically in the post-acute care setting, is to provide the service more precisely.”