A therapy-relevant casemix classification system for school-age children with disabilities

Area of Science:

• Pediatric Rehabilitation
• Health Services Research
• Disability Studies

Background:

• Therapy resource allocation for school-aged children with disabilities often lacks objective criteria.
• Existing funding models may not accurately reflect the diverse needs and service requirements of this population.

Purpose of the Study:

• To develop a clinically meaningful classification system for therapy resource use in school-aged children with disabilities.
• To create resource-homogeneous groups that better describe therapy service needs.
• To establish a foundation for fairer service purchasing and funding.

Main Methods:

• A work-time allocation survey of physical, occupational, and speech therapy services was conducted.
• Data were collected from three disability agencies in Western Australia, studying 644 children.
• The primary outcome measured was the minutes of therapy service time expected over a 10-week school term.

Main Results:

• A nine-group classification system was developed, explaining 46% of the variance in client time.
• The system categorizes children based on mobility (4 groups), primary disorder (2 subgroups), self-care independence (3 subgroups), and expressive communication (3 subgroups).
• This hierarchical classification provides a structured approach to understanding therapy resource utilization.

Conclusions:

• A preliminary classification system for distributing therapy resources to school-aged children with disabilities has been defined.
• This model has the potential to enable fairer service purchasing compared to traditional funding methods.
• Further validation and implementation could improve equity in therapy service provision.