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Patient Characteristics and Treatment Patterns for Speech-Language Pathology Services in Skilled Nursing Facilities.
- Source :
- American Journal of Speech-Language Pathology; Mar2024, Vol. 33 Issue 2, p912-936, 25p
- Publication Year :
- 2024
-
Abstract
- Purpose: Skilled nursing facility (SNF) care has historically been influenced by systemic issues that could impact speech-language pathology (SLP) service provision. However, there has been little study specifically on factors associated with SLP service provision in SNFs. Large administrative data sets are rarely analyzed in SLP research but can be used to understand real-world SLP services. This study investigated associations between patient and facility characteristics and SLP services. Method: Mixed-effects logistic regression models were used to evaluate factors associated with SLP service provision in 2018 Medicare administrative data representing 833,653 beneficiaries. Results: Beneficiaries had higher odds of receiving SLP services when they had neurologic diagnosis (odds ratio [OR] = 3.32), had SLP-related functional impairments (ORs = 1.19-3.41), and received other rehabilitative services (ORs = 3.11- 3.78). Beneficiaries had lower odds of receiving SLP services when they received care from SNFs located in hospitals versus freestanding (OR = 0.45), with need for interpreter services (OR = 0.76) and with thresholding (OR = 0.68), a financially motivated practice. Direction of association varied across racial and ethnic groups and measures of location. Odds of being provided SLP services decreased with increasing communication impairment severity. Conclusions: The results suggest that clinicians are identifying patients with diagnoses most likely to warrant SLP services. However, association disparities and weakening association of service provision with increasing impairment severity have concerning clinical implications. Health services research methods can be used to further explore SLP practices in SNFs to support equitable service provision. [ABSTRACT FROM AUTHOR]
- Subjects :
- SPEECH evaluation
EVALUATION of medical care
STATISTICAL models
PROPRIETARY health facilities
RESEARCH funding
DATABASE management
SECONDARY analysis
COGNITIVE testing
HEALTH insurance reimbursement
PATIENTS
DATA analysis
FOOD consumption
LOGISTIC regression analysis
MEDICARE
HOSPITAL admission & discharge
FUNCTIONAL assessment
QUESTIONNAIRES
SEVERITY of illness index
RETROSPECTIVE studies
POPULATION geography
TREATMENT effectiveness
AGE distribution
NURSING care facilities
NEUROLOGICAL disorders
ODDS ratio
HEALTH facility translating services
MOTIVATION (Psychology)
RACE
COMMUNICATIVE disorders
SUBACUTE care
TRACHEOTOMY equipment
PHYSICIAN practice patterns
FINANCIAL management
RURAL conditions
STATISTICS
RESEARCH
METROPOLITAN areas
DATA analysis software
LENGTH of stay in hospitals
HEARING
PHYSICAL therapy services
CONFIDENCE intervals
SPEECH therapy
ACTIVITIES of daily living
OCCUPATIONAL therapy services
Subjects
Details
- Language :
- English
- ISSN :
- 10580360
- Volume :
- 33
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- American Journal of Speech-Language Pathology
- Publication Type :
- Academic Journal
- Accession number :
- 175974002
- Full Text :
- https://doi.org/10.1044/2023_AJSLP-23-00025