Determinants of utilization of physical rehabilitation services for persons with chronic and disabling conditions: an exploratory study.

OBJECTIVE

To determine which variables influence the receipt of physical rehabilitation services (ie, physical, occupational, speech therapy) for a population of people with chronic and disabling conditions.

DESIGN

A convenience sample of 502 adults with cerebral palsy (CP), multiple sclerosis (MS), and spinal cord injury (SCI), drawn from diverse parts of the United States.

SETTING

Respondents were surveyed in the general community.

PARTICIPANTS

Persons (91% under the age of 65 y) with CP, MS, or SCI who responded to the 1999 component of a national longitudinal survey.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Self-reported need for physical rehabilitation services. Bivariate and multivariate analyses were used to examine variables that influenced utilization of services.

RESULTS

Some 53% of respondents did not receive self-reported needed physical rehabilitation services. Respondents who had Medicaid were more likely than those with Medicare or private insurance to receive physical rehabilitation services. Respondents having a lower household income and poorer health were less likely to receive services.

CONCLUSIONS

Our findings indicate that health care funding sources provide widely disparate coverage for physical rehabilitation services to persons with 3 specific chronic and disabling conditions. Policy-makers and health plan administrators should re-evaluate their coverage of physical rehabilitation services designed to enhance quality of life and reduce the burden of lost independence.