OBJECTIVE To investigate whether indicators of patient need (comorbidity burden; fall risk) predict acute care rehabilitation utilization, and whether this relationship varies across patient characteristics (i.e., demographic characteristics; insurance type). DESIGN Secondary analysis of electronic health records (EHR) data. SETTING Five acute care hospitals. PARTICIPANTS 110,209 adults admitted to five regional hospitals between 2014 and 2018. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Occupational therapy (OT) and physical therapy (PT) utilization. Logistic regression models determined whether indicators of patient need predicted OT and PT utilization. Interactions between indicators of need and both demographic factors (e.g., minority status; presence of significant other) and insurance type were included to investigate whether the relationship between patient need and therapy access varied across patient characteristics. RESULTS Greater comorbidity burden was associated with a higher likelihood of receiving OT and PT. Relative to those with low fall risk, those with moderate and high fall risk were more likely to receive OT and PT. The relationship between fall risk and therapy utilization differed across patient characteristics. Among patients with higher levels of fall risk, those with a significant other were less likely to receive OT and PT; significant other status did not explain therapy utilization among patients with low fall risk. Among those with high fall risk, patients with VA insurance and minority patients were more likely to receive PT than those with private insurance and non-minority patients, respectively. Insurance type and minority status did not appear to explain PT utilization among those with lower fall risk. CONCLUSIONS Patients with greater comorbidity burden and fall risk were more likely to receive acute care rehabilitation. However, the relationship between fall risk and utilization was moderated by insurance type, having a significant other, and race/ethnicity. Understanding the implications of these utilization patterns requires further research.

中文翻译：

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跌倒风险与医院治疗使用之间的关系受人口学特征和保险类型的调节

目的 调查患者需求指标（合并症负担；跌倒风险）是否预测急性护理康复利用，以及这种关系是否因患者特征（即人口学特征；保险类型）而异。设计 电子健康记录 (EHR) 数据的二次分析。设置 五家急症护理医院。参与者 110,209 名成年人在 2014 年至 2018 年期间入住五家地区医院。 干预 不适用。主要观察指标 职业治疗 (OT) 和物理治疗 (PT) 的使用。逻辑回归模型确定患者指标是否需要预测 OT 和 PT 利用率。需求指标与两个人口因素（例如，少数族裔地位；重要他人的存在）和保险类型被包括在内，以调查患者需求和治疗途径之间的关系是否因患者特征而异。结果 更大的合并症负担与更高的接受 OT 和 PT 的可能性相关。相对于跌倒风险低的人，中高跌倒风险的人更有可能接受 OT 和 PT。跌倒风险和治疗利用之间的关系因患者特征而异。在跌倒风险较高的患者中，有其他重要因素的患者接受 OT 和 PT 的可能性较小；重要的其他状态不能解释低跌倒风险患者的治疗使用情况。在跌倒风险高的人群中，VA 保险的患者和少数民族患者分别比私人保险和非少数民族患者更可能接受 PT。保险类型和少数族裔身份似乎不能解释跌倒风险较低的人使用 PT 的原因。结论 合并症负担和跌倒风险较大的患者更有可能接受急性护理康复。然而，跌倒风险和使用率之间的关系受保险类型、具有重要意义的其他人和种族/民族的影响。了解这些利用模式的含义需要进一步研究。结论 合并症负担和跌倒风险较大的患者更有可能接受急性护理康复。然而，跌倒风险和使用率之间的关系受保险类型、具有重要意义的其他人和种族/民族的影响。了解这些利用模式的含义需要进一步研究。结论 合并症负担和跌倒风险较大的患者更有可能接受急性护理康复。然而，跌倒风险和使用率之间的关系受保险类型、具有重要意义的其他人和种族/民族的影响。了解这些利用模式的含义需要进一步研究。