Article

A growing body of research suggests that greater continuity of health
care is positively associated with improved outcomes of patients. However, few
studies have examined this issue in the context of physical therapy.
The purpose of this study was to evaluate whether the level of continuity in the
provider (provider continuity) of physical therapy services was related to
outcomes in a population of patients receiving home health care. DESIGN: This was
a retrospective observational study. METHODS: Clinical and administrative records
were retrieved for a population of adult patients receiving physical therapy
services from a large, urban, not-for-profit certified home health care agency in
2009. Descriptive and multivariable analyses were used to examine how the level
of provider continuity, calculated by use of a formula that models dispersion in
contact between the patient and the providers of physical therapy services,
varied across characteristics and outcomes of patients. RESULTS: Logistic
regression analyses indicated that patients with lower levels of provider
continuity had significantly higher odds of hospitalization (odds ratio
[OR]=2.06, 95% confidence interval [CI]=1.90-2.23) and lower odds of improvements
in the number of activity limitations (OR=0.85, 95% CI=0.80-0.92) and in the
severity of activity limitations (OR=0.85, 95% CI=0.78-0.93) between the
beginning and the end of the home health care episode. LIMITATIONS: Baseline
clinical characteristics associated with continuity of care suggest some level of
indication bias. Outcome measures for activities of daily living were limited to
patients who were not hospitalized during their home health stay. CONCLUSIONS:
These findings build upon research suggesting that continuity in the
patient-provider relationship is an important determinant of outcomes of
patients.

Langue : ANGLAIS