Investigating Disparities in Physical Therapy Utilization: An Intersectionality Perspective.

Area of Science:

• Health Services Research
• Health Disparities
• Physical Therapy Utilization

Background:

• Understanding factors influencing outpatient physical therapy (PT) utilization is crucial for equitable healthcare access.
• Previous research indicates potential disparities based on patient demographics, but an intersectional approach is needed.

Purpose of the Study:

• To investigate the individual and intersectional roles of race, ethnicity, language, insurance, and socioeconomic status on outpatient PT utilization.
• To examine differences in PT appointment scheduling and attendance rates based on these demographic factors.

Main Methods:

• Retrospective cohort study of 61,125 patients referred for outpatient PT.
• Analysis of electronic medical records data from July 2021 to July 2022, including visit completion, race, ethnicity, language, insurance, and zip code.
• Multiple logistic regression models with and without interaction terms to assess demographic associations with PT scheduling and attendance.

Main Results:

• Race, language, and income significantly influenced PT scheduling and attendance.
• Black or African American patients had higher scheduling but lower attendance rates; Asian patients showed the opposite trend compared to White patients.
• Non-English speakers and lower socioeconomic status were associated with reduced PT scheduling and attendance, with income's benefits varying across racial and linguistic groups.

Conclusions:

• Significant disparities exist in outpatient physical therapy utilization based on race, language, and income.
• Intersectional analysis revealed amplified inequities, particularly between race/income and language/income, emphasizing the need for nuanced strategies to address PT access barriers.