Who Receives Rehabilitation in Canadian Long-Term Care Facilities? A Cross-Sectional Study

Abstract

Purpose: To describe the proportion of residents receiving occupational therapy (OT) and physical therapy (PT) and the factors associated with receiving PT in long-term care (LTC) facilities across five provinces and one territory in Canada. Methods: Using a population-based, retrospective analysis of crosssectional data, the proportion of LTC facility residents in each province or territory receiving three different amounts (time and frequency) of PT, OT, or both before July 1, 2013, was calculated according to the Resource Utilization Groups-III rehabilitation classifications. Twenty-three variables from the Resident Assessment Instrument 2.0, such as age and cognition, were examined as correlates; those significant at p < 0.01 were included in a multivariate logistic regression. Results: Between 63.7% and 88.6% of residents did not receive any PT or OT; 0.8%-12.6% received both PT and OT; 5.8%-29.5% received an unspecified amount of PT; 1.9%-7.0% received 45 minutes or more of PT 3 days or more per week; and fewer than 1% received 150 minutes or more of PT on 5 or more days per week. Province, age, cognitive status, depression, clinical status, fracture, multiple sclerosis, and self-rated potential for improvement were associated with PT irrespective of time intensity. Conclusions: The proportion of LTC residents receiving rehabilitation services varies across Canada and appears to be associated with physical impairments and the potential for improvement; older residents with cognitive impairment or mood disorders are less likely to receive rehabilitation services. Future recommendations should consider what is driving the patterns of service use, determine whether the resources available are appropriate, and address the most appropriate goals for residents in LTC.Key Words: aged; long-term care; occupational therapy; rehabilitation. RÉ SUMÉObjet: Dé crire la proportion de ré sidents qui reç oivent des soins d'ergothé rapie (ET) et de physiothé rapie (PT) ainsi que les facteurs associé s à la ré ception de soins de PT dans des é tablissements de soins de longue de cinq provinces et d'un territoire au Canada. Mé thodes: À l'aide d'une analyse ré trospective de donné s transversales fondé e sur la population, la proportion de ré sidents des é tablissements de soins de longue duré e dans chaque province ou territoire qui recevaient trois combinaisons diffé rentes (temps et fré quence) de soins de PT ou d'ET avant le 1 er juillet 2013 a é té calculé e en fonction des groupes d'utilisation des ressources-classifications de ré adaptation III. Un total de 23 variables de la mé thode d'é valuation RAI 2.0, comme l'â ge et la cognition, ont é té examiné es en tant que corré lats; les variables significatives au seuil de p < 0.01 ont é té incluses dans une ré gression logistique à variables multiples. Ré sultats: De 63,7% à 88,6% des ré sidents n'ont pas reç u de soins de PT ou d'ET; de 0,8% à 12,6% des ré sidents ont reç u les deux types de soins; de 5,8% à 29,5% des ré sidents ont reç u une quantité non pré c...

Study Protocol and Baseline Comparisons for a Pan-Canadian Initiative to Reduce Inappropriate Use of Antipsychotics in Long-Term Care Homes

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