Rehabilitation Therapy and Multimorbidity: A Retrospective Cohort Study

Abstract

Aims

Home care rehabilitation therapists can address the functional health needs of those with multimorbidity. This study described individuals with multimorbidity receiving home care rehabilitation therapy and examined the relationship between receipt of rehabilitation therapy and hospital utilization.

Methods

The cohort included long-stay home care clients experiencing multimorbidity who were discharged from an inpatient rehabilitation setting (N = 5,234) between 2007 and 2015. Multivariable logistic regression was used to examine the association between receipt of rehabilitation therapy and hospitalization.

Results

Nearly 40% of this cohort had 5+ chronic conditions. Those receiving only rehabilitation therapy were less likely to be readmitted to the hospital (OR = 0.68; 95% CI: 0.51–0.92), and less likely to use emergency services (OR = 0.80; 95% CI: 0.66–0.97) at the 3-month timeframe. Similar trends were observed at the 12-month timeframe.

Conclusions

Individuals with multimorbidity have complex health needs and home care rehabilitation therapists aid in sustained discharges and influence subsequent health utilization.

Keywords:

• Occupational therapy
• physical therapy
• home care
• multimorbidity
• inpatient rehabilitation
• healthcare utilization

Acknowledgments

This document used data adapted from the Statistics Canada Postal Code^OM Conversion File, which is based on data licensed from Canada Post Corporation, and/or adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from © Canada Post Corporation and Statistics Canada. Parts of this material are based on data and information compiled and provided by CIHI and the Ontario Ministry of Health. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Parts of this material are based on data and information compiled and provided by Ontario Health (OH). The analyses, conclusions, opinions, and statements expressed herein are solely those of the author(s), and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. We thank the Toronto Community Health Profiles Partnership for providing access to the Ontario Marginalization Index. We thank IQVIA Solutions Canada Inc. for the use of their Drug Information File. Additionally, the authors acknowledge the Ontario Ministry of Health and Long-Term Care: IntelliHEALTH ONTARIO for data used in the cohort creation. We thank the Toronto Community Health Profiles Partnership for providing access to the Ontario Marginalization Index.

Author contributions

AM was responsible for the development of the research study, data analysis and interpretation, and writing the manuscript. WL created the dataset used in this study and was involved in SAS code review and analysis. CD provided input regarding conceptualization, refining the research question, guidance in writing the manuscript, and editorial feedback. JT provided statistics and analytical recommendations, and editorial feedback. JM provided guidance in conceptualization, interpretation of the results, and editorial feedback. The author(s) read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organizations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: [email protected]). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification.

Additional information

Funding

This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). This study also received funding from the Ontario Society of Occupational Therapists Research Fund.