The American Physical Therapy Association (APTA) and American Occupational Therapy Association (AOTA) have published summary materials of the Dobson DaVanzo & Associates Therapy Outcomes in Post-Acute Care Settings (TOPS) study. This study examined the relationship of physical and occupational therapy to measured changes in reported functional independence and readmissions. Overall, we found that therapy intensity is directly and positively related to improvements in functional ability and post-discharge readmission rates.
The TOPS study used Medicare claims and post-acute care assessment data (OASIS, IRF-PAI and MDS) to assess the amount of therapy received during a stay and functional impairment of core activities of daily living and mobility at admission and discharge. This allowed us to measure functional improvement while controlling for important beneficiary health and service use factors. Post-acute care (PAC) settings studied – Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, and Home Health Agencies – differed substantially in their approaches to care provision as well as measurement of key functional status items. While we were able to compensate for this in the study, these differences precluded direct comparison across studies, with strong implications for the future of a unified PAC payment system.
Summary TOPS study materials are available from APTA: https://www.apta.org/article/2021/04/05/apta-aota-joint-statement.