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Physical therapy in ED after a fall may reduce revisits

Older adults presenting to the ED for a ground level fall who received physical therapy services during the initial visit had substantially lower odds of returning to the ED, according to research published in the Journal of the American Geriatrics Society.

“Falls are the leading cause of morbidity and mortality in Americans aged 65 and older. ... Older adults presenting to the ED for a fall are at high risk of ED revisits and mortality, with some estimates indicating that 25% of individuals presenting to the ED for a fall had at least one ED revisit and that 15% died within the following year,” Adriane Lesser, MS, from West Health Institute, La Jolla, California, and colleagues wrote.

Lesser and colleagues analyzed Medicare claims data to investigate if providing physical therapy in the ED improves outcomes and revisit rates for adults aged 65 years or older who fell. Patients who died during the follow-up period were excluded, resulting in the inclusion of 17,875 claims for fall-related ED visits with physical therapy services and 178,410 claims for fall-related ED visits without physical therapy services.

Physical therapy services in the ED was defined as receiving information, diagnosis and referral for follow-up physical therapy after discharge during the index visit.

The researchers found that physical therapy was provided to only 3.2% of older adults who visited the ED for a fall. Patients who received physical therapy in the ED after a ground-level fall were significantly less likely to revisit the ED for another fall within 30 days (OR = 0.655) and 60 days (OR = 0.684), compared with those who did not receive physical therapy.

“Our results suggest that EDs could play an important role in reducing fall-related ED revisits by linking individuals who have fallen with appropriate follow-up care,” Lesser and colleagues concluded.

“Additional analyses could assess this trend in more depth, including evaluation of outpatient physical therapy services after a consultation in the ED,” they added. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.