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Physical and Occupational Therapy Use and Cost After Common Hand Procedures
Romil Fenil Shah1, Steven Zhang1, Kevin Li1
1VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
The Journal of Hand Surgery
|November 23, 2019
Summary
Physical therapy (PT) and occupational therapy (OT) use after hand surgery has increased significantly. Substantial regional variations in PT/OT utilization exist, highlighting opportunities for healthcare policy to improve care value.
Area of Science:
- Orthopedic surgery outcomes research
- Rehabilitation medicine utilization analysis
Background:
- Routine physical therapy (PT) and occupational therapy (OT) post-hand procedures lack consensus.
- Evaluating current PT/OT use, trends, regional variations, and costs is crucial.
Purpose of the Study:
- Assess baseline PT/OT use after common hand procedures.
- Analyze changes in PT/OT utilization over time.
- Investigate regional prescribing patterns and associated costs.
Main Methods:
- Retrospective analysis of outpatient claims data (2007-2015).
- Included procedures: carpal tunnel release, trigger finger, arthritis, tenosynovitis, ganglion cyst, distal radius fracture.
- Evaluated 90-day postoperative therapy incidence, reimbursement, and regional variations using compound annual growth rates (CAGRs).
Main Results:
- 90-day PT/OT utilization was 14.0%, increasing with an 8.3% average CAGR.
- Cost per visit remained stable (0.63% average CAGR).
- Northeast region showed significantly higher PT/OT use compared to South and West, except for carpometacarpal arthritis.
Conclusions:
- PT/OT use has risen post-hand procedures.
- Significant geographical disparities in therapy utilization are evident.
- Standardizing care and reducing unwarranted variation can enhance healthcare value.
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