Initial Investigation into the Key Differences for Achieving Patient-Reported Measure Outcome Goals in Concussion Rehabilitation

Abstract

<h3>Research Objectives</h3> The purpose of this study was to examine differences in patient demographics, clinical, and organization characteristics between patients who achieved the FOTO-predicted Discharge Status Functional score in concussion rehabilitation. <h3>Design</h3> This retrospective study included all patients diagnosed with a concussion and admitted to an outpatient physical therapy network between September of 2021 to April 2022. Included data points consisted of sex, arrival rate, insurance provider, number of visits, and a functional outcome measure. <h3>Setting</h3> Commercial provider of physical therapy. <h3>Participants</h3> Participants with available data points who attended physical therapy (N=187) <h3>Interventions</h3> Outpatient physical therapy. <h3>Main Outcome Measures</h3> Patient reported outcomes were collected using Focus On Therapeutic Outcomes (FOTO), which is patient-self reported functional outcome measures that providers risk-adjusted scores. FOTO produces a "Discharge FS Score' which is a risk-adjusted predicated score the patient should achieve within the episode of care (Deutscher et al., 2018). <h3>Results</h3> Review of an outcome database identified 187 eligible participants with a mean age of 36.64 (SD = 17.33). Of these participants 78 (41.71%) were male,09 (58.29%) were female, 88 (47.06%) were commercial insurance, 18 (9.63%) were federal insurance, and 81 (43.32%) were classified as other. A majority of patients attended < 9 visits (n = 73; 39.04%) with a frequency of < 2 visits per week (n=137; 73.26%). There were no significant differences for any organization variables and FOTO scores. A majority of patients who successfully completed their course of care achieved the FOTO score (n=74; 77.89%; p < 0.001). In contrast, patients who were discharged secondary to a plateauing effect or insurance limitations were less likely to achieve the FOTO score (p < 0.001). <h3>Conclusions</h3> A majority of patients who attend physical therapy after a concussion successfully achieve patient-self reported functional outcomes. There were no significant differences in outcomes between sex, age, number of visits, frequency of visits, and number of rendering providers. Patients who were successfully discharged were more likely to achieve patient-reported functional outcomes compared to those discharged due to plateau or insurance limitations. <h3>Author(s) Disclosures</h3> None