Health Status, Goal Attainment, and Number of Visits of Knee Impaired Physical Therapy Patients: A Comparison of HMO vs Fee-For Service Insurance Plans

The turf battle between capitated medicine and traditional indemnity insurance plans continues. Questions and concerns raised by health care providers regarding differences between the two systems remain unanswered. Few studies exist regarding differences in quality of care and health status of physical therapy patients from health Maintenance organizations (HMOs) and fee-for-service (FFS) plans. The purpose of this retrospective study was to describe differences between HMO and FFS patients in the knee impaired population, on three parameters: (1) attainment of physical therapy goals, as determined by the physical therapist, (2) patients perceived health status, determined by the Medical Outcome Study 12-Item Short-Form Health Survey (MOS SF-12) self-administered questionnaire, and (3) average number of visits. Data from a sample of the knee impaired population treated in 272 outpatient orthopedic physical therapy clinics across the United States were obtained from the Focus on Therapeutic Outcomes (FOTO) database. Standardized forms and questionnaires used in patient, clinician, and administrative data collection were completed during initial and discharge physical therapy visits. ANOVAS and t-tests were used to analyze differences between HMO and FFS patients on each parameter. Linear regression models were used to assess interactions between variables and determine the predictors of outcome. The results of this investigation were that health status and physical therapy goal attainment were not influenced by payment source. Patients from both HMO and FFS plans reported improved health status related to the number of visits, however there was no evidence that the number of visits affected goal attainment status.

Name thesis:degree_name

Master of Science

Level thesis:degree_level

Masters

Discipline thesis:degree_discipline

Physical Therapy

Grantor

Southwest Texas State University

Year dc:date.issued

1998

Author dc:creator

• Schwanz, Lori A.

Advisor dc:contributor.advisor

• Sanders, Barbara

Committee members dc:contributor.committeemember

• Bezner, Janet
• Melzer, Barbara

• knee
• injuries
• health maintenance organizations
• health insurance

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10877/21582

OAI identifier oai:identifier

oai:digital.library.txst.edu:10877/21582