Abstract:
OBJECTIVE:To determine if there was a change in the number of outpatient physical therapy (PT) and occupational therapy (OT) visits for Medicare beneficiaries, and in the number of beneficiaries receiving extended courses of >12 therapy visits, after the Jimmo vs Sebelius settlement. DESIGN:Cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) comparing calendar years 2011-2012 to 2014-2015. SETTING:Community in-home survey. PARTICIPANTS:Medicare Part-B recipients who received outpatient PT/OT (N=1183, median age 70.8) during pre-Jimmo settlement (2011-2012) and post-Jimmo settlement (2014-2015) time periods. INTERVENTION:Not applicable. MAIN OUTCOME MEASURES:Number of therapy visits/patient/year and number of subjects who received >12 therapy visits/year estimated by linear and logistic regressions controlling for potential confounders (age, body mass index [BMI], and geographic region). RESULTS:The unadjusted median number of therapy visits/year increased from 7 to 8 after the settlement. Linear regression estimated a 1.02 increase in the number of therapy visits after the settlement (95% confidence interval [CI] 0.23, 1.80; P=.01). The odds of having >12 therapy visits/year increased (odds ratio=1.41; 95% CI 1.02,1.96; P=.04). We observed a significant interaction between race and the effect of the settlement on the odds of having >12 therapy visits (OR 3.64; 95% CI 1.58, 8.39). Non-Hispanic white subjects saw an increase in utilization while a combined group of black, Hispanic and Asian subjects' utilization declined. CONCLUSION:Utilization of outpatient PT/OT changed after the 2013 Jimmo settlement. Further research is needed to determine the effect on patient outcomes and cost.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Dee J,Littenberg Bdoi
10.1016/j.apmr.2018.07.435subject
Has Abstractpub_date
2019-01-01 00:00:00pages
78-85issue
1eissn
0003-9993issn
1532-821Xpii
S0003-9993(18)31171-7journal_volume
100pub_type
杂志文章abstract::Using standardized data abstracted from a representative sample of hospitals in north-central Alabama, we analyze significant social and physical factors in acute care discharge referral patterns for 756 people with traumatic brain injury (TBI). When a Physical Medicine and Rehabilitation specialist is involved in the...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the immediate effect of repetitive wrist extension on grip strength in patients with distal radial fracture. DESIGN:Interventional study. SETTING:Patients who were admitted to a hospital department of occupational therapy. PARTICIPANTS:Consecutive patients with a unilateral distal radial fractu...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.apmr.2014.09.024
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To determine the degree of impairments and activity limitations and their interrelationship in complex regional pain syndrome type I (CRPS type I). DESIGN:Cross-sectional study interrelating impairments and objectively measured activity limitations. SETTING:Ambulatory and home environment. PARTICIPANTS:Thi...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2003.06.026
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge. DESIGN:A prospective observational study using qualitative and quantitative evaluation. SETTING:Follow-up of hospital patients in their home setting after discharge from a metropoli...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2011.04.009
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:To assess in healthy adults the validity and the inter- and intrarater reliability of the Internet-based Shaw Gait Assessment (SGA). DESIGN:Concurrent test-retest reliability and validity study with participants, 4 raters, and the Elite motion analysis system (used as the criterion standard). SETTING:Motio...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2004.09.019
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of 2 home-based behavioral interventions for wheelchair users to promote exercise adoption and maintenance over 12 months. DESIGN:Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner ava...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.apmr.2013.07.006
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To examine the reliability, validity, and factor structure of the Late Life Disability Instrument (LLDI) in individuals who use power wheelchairs as their primary means of mobility. DESIGN:A 4-week, test-retest study design. SETTING:Five Canadian cities. PARTICIPANTS:The validity sample included 115 new an...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2014.05.020
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To compare a sample of adolescents with sport-related concussion (SRC) who were prescribed rest with 2 arms of a randomized controlled trial comparing aerobic exercise with placebo-like stretching. We also compared sex differences across the 3 approaches to treatment. DESIGN:Quasi-experimental trial. SETTIN...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2019.07.003
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:To assess reliability of traditional and fractal dimension measures of quiet stance center of pressure (COP). DESIGN:Cross-sectional study. SETTING:University laboratory. PARTICIPANTS:Thirty young healthy men (n=20) and women (n=10) (mean age, 23 y). INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:C...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章
doi:10.1016/j.apmr.2005.05.014
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of a late-phase exercise program for patients who underwent total hip arthroplasty (THA) 4 to 12 months earlier. DESIGN:A single-blind, randomized controlled trial. SETTING:Exercises were performed in subjects' homes. Exercise instruction and measurements taken before and after th...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.apmr.2003.11.022
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To determine and describe the demographics and functional outcomes of persons who require inpatient rehabilitation for severe penetrating head injury resulting from a gunshot wound to the head. DESIGN:Data were collected prospectively from the time of admission to acute care through discharge from inpatient ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1053/apmr.2001.18226
更新日期:2001-03-01 00:00:00
abstract::This report presents the first description of direct peripheral nerve compression as a complication of brachial artery-basilic vein vascular access in patients with uremia who are receiving long-term hemodialysis. Three patients are presented. An expanding basilic vein hematoma compressed the radial nerve in one patie...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:To determine if bone mineral density (BMD) is associated with the probability of stress fractures in premenopausal women. DESIGN:Case-control study. SETTING:Large Army post, Fort Lewis, WA. PARTICIPANTS:Twenty-seven active duty Army women with documented stress fractures within the last 2 years and 158 fem...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(00)90225-9
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To determine physiological energy cost with Blatchford's "Intelligent Prosthesis" (IP) compared to energy cost with a conventional pneumatic swing phase control (PSPC) mechanism. DESIGN:Before-After trial: subjects fitted with IP walked on programmable treadmill at speeds: 6 min slow, 6 min fast, 8 min while...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(97)90044-7
更新日期:1997-03-01 00:00:00
abstract::The functional effects of three types of therapy for subjects with long-term incomplete cervical spinal cord injuries were investigated. Men and women, aged 18 to 45 years, were assigned to one of four groups using a restricted randomization process. The training period was divided into two consecutive eight-week time...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVE:To estimate, for persons with multiple sclerosis (MS), the extent to which peak oxygen consumption (Vo(2)peak) can be predicted by the results on submaximal tests. DESIGN:Cross-sectional study. SETTING:Three MS clinics in the Greater Montreal region, Canada. PARTICIPANTS:A center-stratified random sample o...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/j.apmr.2010.06.005
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To improve clinical decision making in posttraumatic neck pain by investigating the additional value of fear-avoidance variables in predicting chronic neck pain disability. DESIGN:An inception cohort with baseline assessment 1 week posttrauma and outcome assessment 24 weeks posttrauma. Predictive factors inc...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2003.06.019
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To determine the involvement of physiatrists and physical medicine and rehabilitation (PM&R) departments in the acute care of patients admitted to level I trauma centers. DESIGN:An 18-question survey. SETTING:Adult, level I trauma center. PARTICIPANTS:Physiatrists, administrative directors, and others invo...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(98)90210-6
更新日期:1998-01-01 00:00:00
abstract::Eighty-one patients with symptomatic osteoarthritis of the thumb took part in a blinded, controlled study to assess the effectiveness of 0.9 mw continuous wave HeNe laser treatment. The subjects were randomly placed in either a control group or a treatment group. In each group the carpometacarpal (CMC), metacarpophala...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of combined intercostal and diaphragm pacing to maintain independence from mechanical ventilation. DESIGN:A prospective trial. SETTING:Clinical research center at a large tertiary hospital. PARTICIPANTS:Four ventilator-dependent subjects with spinal cord injury with only unilater...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章
doi:10.1016/j.apmr.2004.11.027
更新日期:2005-06-01 00:00:00
abstract::The Physical Therapy Department at Kessler Institute for Rehabilitation has been fabricating temporary prostheses since 1967. Initially, these below-knee limbs were constructed with a plaster socket attached to a modular type prosthesis. Early in 1970, we began to use polysar, a thermoplastic compound. It is nonirr...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::Radial sensory conduction has traditionally been performed by stimulating the nerve at the wrist, recording from the thumb or the base of the first web space. This paper describes a technique for measuring conduction in the more distal branches on the dorsum of the hand. Comparison is made with dorsal ulnar sensory co...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVES:To summarize adverse events reported in randomized controlled trials that applied progressive resistance strength training in older adults and to examine factors that might be associated with these events. DESIGN:After systematic searches of databases, 2 reviewers independently screened and extracted advers...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:10.1016/j.apmr.2010.06.001
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To better understand the needs of spouses who provide care to spinal cord injury (SCI) survivors, by comparing their self-perceptions and complaints with those of their partners with disabilities and with those of spouses who do not provide care. DESIGN:Survey, including demographics, health concerns questio...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(97)90194-5
更新日期:1997-08-01 00:00:00
abstract::Principles of fairness in testing require that all test takers, including people with disabilities, have an equal opportunity to demonstrate their capacity on the construct being measured. Measurement design features and assessment protocols can pose barriers for people with disabilities. Fairness in testing is a fund...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2017.06.036
更新日期:2018-01-01 00:00:00
abstract::To assess the value of exercise training after traumatic brain injury (TBI), 14 sedentary adults with TBI performed a supervised circuit training program three times per week for 16 consecutive weeks. The program was designed to include equal volumes of both aerobic and neuromuscular training to increase the subjects'...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVES:To describe the course of fatigue during the first year poststroke and to determine the relation between fatigue at 1 year poststroke and personal characteristics, stroke characteristics, and poststroke impairments. DESIGN:Inception cohort. SETTING:Rehabilitation center. PARTICIPANTS:Patients (N=167) with...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2005.10.005
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To determine immunogenicity and optimum timing for administering the 23-valent pneumococcal vaccine after spinal cord injury (SCI). DESIGN:Double-blind, randomized, placebo control study. SETTING:SCI unit in a tertiary care medical center and community. PARTICIPANTS:Eighty-seven persons with recent SCI. I...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0003-9993(98)90410-5
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To quantitatively assess the antispastic effect of intrathecally administered baclofen on muscle stiffness in spastic patients. DESIGN:Case-control study. SETTING:Clinical laboratory in a university hospital of a city of more than 1,000,000 inhabitants. PARTICIPANTS:Eighteen healthy adult volunteers (9 men...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(00)90071-6
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effectiveness of a home-based multiple-speed treadmill training program to improve gait performance in persons with a transfemoral amputation (TFA). DESIGN:Repeated measures. SETTING:Research laboratory. PARTICIPANTS:Individuals with a TFA (N=8) who had undergone a unilateral amputation ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2013.08.001
更新日期:2013-12-01 00:00:00