Study: Physical and Occupational Therapy Improves Pneumonia Patient Outcomes

The more physical and occupational therapy visits pneumonia patients receive while hospitalized, the lower the risk of readmission or death, study finds.

Physical and occupational therapy for pneumonia patients in the acute care setting lowers hospital readmission and mortality risk, a recent research article says.

For adults, pneumonia is a leading cause of mortality and hospitalization. The respiratory condition also is a common reason for hospital readmission. Since 2012, Medicare has been penalizing hospitals financially for readmissions linked to several targeted conditions including pneumonia.

The recent research article, which was published by JAMA Network Open, is based on information collected from more than 30,000 patients with pneumonia or influenza-related conditions at a dozen acute care hospitals in Pennsylvania. The number of physical and occupational therapy visits provided during hospitalizations was categorized as none, low (1-3), medium (4-6), or high (greater than 6).

The study features several key data points:

• 18.4% of patients had a hospital readmission within 30 days of discharge
   
• 3.7% of patients died within 30 days of discharge
   
• Compared to no therapy visits, risk of 30-day readmission or death decreased as therapy visits increased: low visits, odds ratio 0.98; medium visits, odds ratio 0.89; and high visits, odds ratio 0.86
   
• The inverse relationship between therapy visits and risk of 30-day readmission or death was stronger in patients with low functional mobility and individuals discharged to a community setting
   
• Receiving both physical and occupational therapy visits was associated with a decreased risk of 30-day readmission or death (odds ratio 0.90)
   
• Compared to having no therapy visits, patients discharged to home who had at least 7 therapy visits had a decreased risk of hospital readmission or death within 30 days of discharge (odds ratio 0.68)

"In this study, we examined the association between therapy visits and the risk of 30-day readmission or death in adults hospitalized with a diagnosis of pneumonia or influenza-related conditions. We found that the number of therapy visits received was inversely associated with the risk of readmission or death. This association was greater in the subgroups of patients with lower mobility and patients discharged to the community," the research article's co-authors wrote.

Interpreting the data

The study's co-authors speculated about why the association between therapy and positive outcomes was strongest for patients who had lower mobility or were discharged to home.

"These findings make theoretical sense given that individuals with lower mobility are likely to benefit from therapy. Contact with a [physical therapist] or [occupational therapist] for individuals discharged to the community with functional limitations may also ensure that the patient receives appropriate follow-up care in a timely manner," they wrote.

Readmission risk may have been reduced because therapy decreased the level of functional decline patients experienced during their hospitalization, the co-authors wrote. "Because pneumonia and influenza-related conditions are likely to resolve with appropriate medical management, therapy may be particularly useful in targeting impaired function, a modifiable risk factor for hospital readmission."

The number of therapy visits received was a key factor in reducing the risk of hospital readmission or death, the co-authors wrote. "Our findings also suggest that it is the number of therapy visits received, more than the types of therapists seen, that was associated with the risk of readmission or death."

Related: How a Pennsylvania Health System Slashed Readmissions 25%