Observational studyArchives of physical medicine and rehabilitation2018
Association Between Therapy Intensity and Discharge Outcomes in Aged Medicare Skilled Nursing Facilities Admissions.
Observational study in Archives of physical medicine and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Effect of Enhanced Medical Rehabilitation on Functional Recovery in Older Adults Receiving Skilled Nursing Care After Acute Rehabilitation: A Randomized Clinical Trial.JAMA network open · 2019Trial
- Feasibility of a Multicomponent Frailty Intervention During Post-Acute Rehabilitation in Skilled Nursing Facilities.Journal of the American Geriatrics Society · 2026Article
- The role of declining therapy volumes in skilled nursing facility outcomes: a mediation analysis.Health affairs scholar · 2026Article
- Impact of intensive, multidisciplinary neurorehabilitation on functional independence following pediatric acquired brain injury (ABI): A matched cohort study.Journal of pediatric rehabilitation medicine · 2026Article
- Shaping older adults' care policy: a scoping review of key determinants in post-acute and community reintegration transitions.BMC health services research · 2025Article
- Skilled Nursing Facility Rehabilitation Intensity and Successful Discharge in Persons with Dementia.Journal of the American Medical Directors Association · 2024Article
- Is More Always Better? Financially Motivated Therapy and Patient Outcomes in Skilled Nursing Facilities.Archives of physical medicine and rehabilitation · 2024Article
- Skilled Nursing Facility Organizational Characteristics Are More Strongly Associated With Multiparticipant Therapy Provision Than Patient Characteristics.Physical therapy · 2022Article
- Therapy Staffing in Skilled Nursing Facilities Declined after Implementation of the Patient-Driven Payment Model.Journal of the American Medical Directors Association · 2021Article
- Improvement in Activities of Daily Living during a Nursing Home Stay and One-Year Mortality among Older Adults with Sepsis.Journal of the American Geriatrics Society · 2021Article
- Factors Associated with Duration of Rehabilitation Among Older Adults with Prolonged Hospitalization.Journal of the American Geriatrics Society · 2020Article
- Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study.JMIR mHealth and uHealth · 2020Observational
- User-Dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: Mixed Methods Pilot Study.JMIR mHealth and uHealth · 2020Article
- Benefits of direct patient discharge to outpatient physical therapy after total knee arthroplasty.Disability and rehabilitation · 2020Article
- Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society.Geriatric orthopaedic surgery & rehabilitation · 2020Review
- Rehabilitation Therapy for Nursing Home Residents at the End-of-Life.Journal of the American Medical Directors Association · 2019Observational
- Challenging rehabilitation environment for older patients.Clinical interventions in aging · 2019Review
- The association of patient-reported improvement and rehabilitation characteristics with mortality.Geriatric nursing (New York, N.Y.)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
objectivesTo determine the association between therapy intensity and discharge outcomes for aged Medicare skilled nursing facilities (SNFs) fee-for-service beneficiaries and to determine the association between therapy intensity and time to community discharge.
designRetrospective observational design.
settingSNFs.
participantsAged Medicare fee-for-service beneficiaries (N=311,338) in 3605 SNFs.
interventionsThe total minutes of physical therapy, occupational therapy, and speech therapy per day were divided into intensity groups: high (≥60min); medium-high (45-<60min); medium-low (30-<45min); and low (<30min).
main outcome measuresFour discharge outcomes-community, hospitalization, permanent placement, and death-were examined using a multivariate competing hazards model. For those associated with community discharge, a Poisson multivariate model was used to determine whether length of stay differed by intensity.
resultsHigh intensity therapy was associated with more community discharges in comparison to the remaining intensity groups (hazard ratio, .84, .68, and .433 for medium-high, medium-low, and low intensity groups, respectively). More hospitalizations and deaths were found as therapy intensity decreased. Only high intensity therapy was associated with a 2-day shorter length of stay (incident rate ratio, .95).
conclusionsHigh intensity therapy was associated with desirable discharge outcomes and may shorten SNF length of stay. Despite growing reimbursements to SNFs for rehabilitation services, there may be desirable benefits to beneficiaries who receive high intensity therapy.
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