Patients who received more physical therapy visits at home were able to recover better from knee-replacement surgery, according to a team of physical therapy researchers from the University of Colorado School of Medicine.
The optimal number of home care visits by physical therapists was six to nine.
In addition, patients living in a rural area or who had other complex medical conditions were associated with fewer, not more, home health care visits, according to the researchers, in a media release from University of Colorado Anschutz Medical Campus.
The study, published in The Journal of Bone and Joint Surgery, aimed to assess the effectiveness of in-home physical therapy care for patients who have had knee replacement surgery.
The researchers analyzed Medicare home health care claims for patients treated with total knee arthroplasty in 2012 who received home health care services for their post-operation rehabilitation. The survey of cases covered urban and rural locations across the United States. About 68% of the patients were women. Eighty-nine percent were Caucasian.
Based on a review of 5,967 Medicare beneficiaries, those who received fewer than five home health care visits by a physical therapist were associated with greater difficulty returning to activities of daily living, the release explains.
“This study is important because some people have recommended saving money by curtailing the use of physical therapists for in-home care for patients who receive total knee arthroplasty,” says lead author Jason R. Falvey, PhD, research physical therapist with the CU School of Medicine’s Physical Therapy Program, in the release.
“But those recommendations are based on a lack of research. Our study shows that patients recover better when they receive appropriate care.”
The Centers for Medicare and Medicaid Services has introduced a bundle payment model that combines the costs of hospital, post-acute-care, and outpatient costs associated with total joint replacement. The bundles have the effect of incentivizing the discharge of patients from hospital to home.
“Our study may help care providers prescribe more optimal dosages of at-home physical therapy for these patients who are discharged,” Falvey adds. “Low users of at-home physical therapy often had less social support and more complex medical conditions. Patients who don’t get the home health care visits they need can end up needing future hospitalization or institutionalization. The risks of not providing the appropriate level home health care may result in higher overall healthcare costs in the long term.”
[Source(s): University of Colorado Anschutz Medical Campus, EurekAlert]