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Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services.

Publication ,  Journal Article
Childs, JD; Harman, JS; Rodeghero, JR; Horn, M; George, SZ
Published in: J Orthop Sports Phys Ther
December 2014

STUDY DESIGN: Retrospective analysis of episodes of care. OBJECTIVE: To assess the implications of practice setting (hospital outpatient settings versus private practice) on clinical outcomes and efficiency of care in the delivery of physical therapy services. BACKGROUND: Many patients with musculoskeletal conditions benefit from care provided by physical therapists. The majority of physical therapists deliver services in either a private practice setting or in a hospital outpatient setting. There have not been any recent studies comparing whether clinical outcomes or efficiency of care differ based on practice setting. METHODS: Practices that use the Focus On Therapeutic Outcomes, Inc system were surveyed to determine the specific type of setting in which outcomes were collected in patients with musculoskeletal impairments. Patient outcome data over 12 months (2011-2012) were extracted from the database and analyzed to identify differences in the functional status achieved and the efficiency of the care delivery process between private practices and hospital outpatient settings. RESULTS: The data suggest that patients experience more efficient care when receiving physical therapy in hospital outpatient settings compared to private practice settings, as demonstrated by 3.1 points of greater improvement in functional status over 2.9 fewer physical therapy visits. However, the difference in improvement between settings is less than the minimum clinically important difference of 9 points in functional status outcome score. CONCLUSION: In this cohort, our data suggest that more efficient care was delivered in the hospital outpatient setting compared to the private practice setting. However, we cannot conclude that care delivered in the hospital setting is more cost-effective, because it is possible that any difference in efficiency of care favoring the hospital outpatient setting is more than offset by higher costs of care.

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Published In

J Orthop Sports Phys Ther

DOI

EISSN

1938-1344

Publication Date

December 2014

Volume

44

Issue

12

Start / End Page

955 / 963

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Private Practice
  • Physical Therapy Modalities
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Efficiency, Organizational
 

Citation

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ICMJE
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Childs, J. D., Harman, J. S., Rodeghero, J. R., Horn, M., & George, S. Z. (2014). Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services. J Orthop Sports Phys Ther, 44(12), 955–963. https://doi.org/10.2519/jospt.2014.5224
Childs, John D., Jeffrey S. Harman, Jason R. Rodeghero, Maggie Horn, and Steven Z. George. “Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services.J Orthop Sports Phys Ther 44, no. 12 (December 2014): 955–63. https://doi.org/10.2519/jospt.2014.5224.
Childs JD, Harman JS, Rodeghero JR, Horn M, George SZ. Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services. J Orthop Sports Phys Ther. 2014 Dec;44(12):955–63.
Childs, John D., et al. “Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services.J Orthop Sports Phys Ther, vol. 44, no. 12, Dec. 2014, pp. 955–63. Pubmed, doi:10.2519/jospt.2014.5224.
Childs JD, Harman JS, Rodeghero JR, Horn M, George SZ. Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services. J Orthop Sports Phys Ther. 2014 Dec;44(12):955–963.

Published In

J Orthop Sports Phys Ther

DOI

EISSN

1938-1344

Publication Date

December 2014

Volume

44

Issue

12

Start / End Page

955 / 963

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Private Practice
  • Physical Therapy Modalities
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Efficiency, Organizational