Long-stay home care clients who receive rehabilitation have improved outcomes and lower utilization of costly health services, say authors of an article published online in Archives of Physical Medicine and Rehabilitation. The findings suggest that investment in physical therapy and occupational therapy services for relatively short periods may provide savings to the health care system over the longer term, they add.

This observational study conducted in home care programs in Ontario, Canada, included 99,764 home care clients with musculoskeletal disorders who received a baseline screening using the Resident Assessment Instrument for Home Care, 1 follow-up assessment, and had discharge or death records between 2003 and 2008.

The effects of physical therapy and occupational therapy services on transitions in function state, discharge from home care with service plans complete, institutionalization, and death were assessed using multistate Markov models.

Home care clients with deficiencies in instrumental activities of daily living (IADL) and/or activities of daily living at baseline and who received home-based rehabilitation had significantly increased odds of showing functional improvements by their next assessment (for a state 3 → 2 transition OR = 1.17; for a state 2 → 1 transition OR = 1.36). Receipt of physical therapy or occupational therapy also significantly reduced the odds of mortality and institutionalization in this group.

With increasing numbers of older adults with chronic conditions and limited funding for health care services, it is essential to provide the right services at the right time in a cost-effective manner, the authors add.