Defining Potential Overutilization of Physical Therapy Consults on Hospital Medicine Services.

Martinez, Maylyn; Cerasale, Matthew; Baig, Mahnoor; Dugan, Claire; Robinson, Marla; Sweis, Meghan; Prochaska, Micah; Schram, Andrew et al. · J Hosp Med · 2021

retrospective_cohort · Level III

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Abstract

Appropriate use of inpatient physical therapy services is important for preventing hospital-associated disability (HAD). We assessed potential overutilization of physical therapy consults on hospital medicine services using the Activity Measure-Post Acute Care (AM-PAC) score. Our sample included 3592 unique admissions (mean age, 66 years; 48% women) at a large academic medical center. Based on an AM-PAC cutoff of >43.63 (raw score, 18) in patients who were discharged to home, 38% of physical therapy consults were considered "potential overutilization." Combined with age <65 years, 18% of consults remained "potential overutilization." After adjustment for age, sex, and length of stay, patients admitted with high mobility scores were 5.38 times more likely to be discharged to home (95% CI, 4.36-2.89) compared with those with low mobility scores. Being more judicious with physical therapy consults and reserving skilled therapy for at-risk patients could help prevent HAD while also having a positive impact on healthcare systems.