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 65y) 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.