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  9. Occupational Therapy
  11. Facility-level And Racial Disparities In Access To Inpatient Psychiatric Occupational Therapy Services In The Veterans Health Administration.

Facility-Level and Racial Disparities in Access to Inpatient Psychiatric Occupational Therapy Services in the Veterans Health Administration.

Adam R Kinney1, Molly E Penzenik2, Jeri E Forster3

  • 1Adam R. Kinney, PhD, OTR/L, is Research Health Science Specialist, Veterans Affairs (VA) Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Aurora, CO, and Assistant Professor, Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, Aurora; Adam.Kinney@va.gov.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
|June 11, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Veterans with daily living limitations generally receive occupational therapy in psychiatric care. However, access disparities exist based on race and facility characteristics, highlighting the need for equitable service delivery.

Area of Science:

  • Health Services Research
  • Occupational Therapy
  • Health Disparities

Background:

  • Veterans with limitations in activities of daily living (ADLs) benefit from occupational therapy during inpatient psychiatric care.
  • Disparities in accessing these services among veterans are not well understood.

Purpose of the Study:

  • To determine if ADL limitations correlate with occupational therapy utilization in Veterans Health Administration (VHA) psychiatric care.
  • To examine if facility characteristics influence the association between ADL limitations and occupational therapy use.

Main Methods:

  • Analysis of VHA data from 2015-2020 for 133,844 inpatients.
  • Modified Poisson regression used to model occupational therapy utilization based on ADL limitations and facility factors.
  • Interaction terms assessed how facility characteristics modified the ADL-utilization relationship.

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Main Results:

  • Veterans with ADL limitations were more likely to receive occupational therapy.
  • Higher facility complexity and care quality were associated with increased occupational therapy use.
  • Black veterans had lower utilization rates compared to White, non-Hispanic veterans.
  • The impact of ADL limitations on utilization was weaker in more complex facilities.

Conclusions:

  • While occupational therapy generally aligns with veteran needs (ADL limitations), access is influenced by patient race and facility characteristics.
  • Disparities in access based on race and facility complexity require targeted interventions.
  • Understanding these factors is crucial for developing strategies to ensure equitable access to occupational therapy for all veterans.