Postpartum Physical Therapy Utilization Among Low-Income Patients in San Diego

Area of Science:

• Obstetrics and Gynecology
• Physical Therapy
• Health Services Research

Background:

• Postpartum musculoskeletal issues are common but under-recognized.
• Pelvic floor physical therapy is an effective treatment, yet referral and adherence rates are low.
• Existing research often overlooks diverse patient populations, limiting generalizability.

Purpose of the Study:

• To examine disparities in physical therapy referral and adherence among medically underserved postpartum patients.
• To identify predictors and moderators of adherence to outpatient postpartum physical therapy.

Main Methods:

• Retrospective cohort study utilizing electronic health records.
• Statistical analysis included t-tests, ANOVA, and logistic regression.
• Evaluation of referral rates and adherence factors across different demographic and medical variables.

Main Results:

• Hispanic patients had significantly lower physical therapy referral rates (8.8%) compared to other groups.
• Older age, higher pain, depression, higher education, severe perineal lacerations, higher parity, and gravidity were associated with referral.
• Pain, education, race, and age predicted physical therapy adherence, with Asian race moderating referral-adherence relationship.

Conclusions:

• Postpartum physical therapy referrals exhibit ethnic disparities and remain low overall.
• Patient demographics and medical history significantly influence adherence to physical therapy.
• Future interventions should address social determinants of health and individual medical needs to improve postpartum physical therapy access and adherence.