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Racial and linguistic disparities impact physical therapy (PT) scheduling and attendance. Intersectional analysis reveals amplified inequities, particularly concerning income, highlighting the need for targeted interventions to improve PT access.

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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.