Referral Patterns to Physical Therapy in Elderly Hospitalized for Acute Medical Illness

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Abstract
Referral patterns to physical therapy (PT) during and after hospitalization were studied in an acute care hospital. Non-surgical patients (N = 88) from general medical wards (non-neurological, non-orthopedic) with a mean age of 79.2 were evaluated for walking and transfer ability. The need for assistance in walking and transfers at discharge was compared with referrals to PT during and after hospitalization. At discharge, 45 (51%) of the study patients were dependent in walking and only 22 (47%) had received PT orders. Nineteen (22%) of the study patients were unable to transfer from bed to chair independently at discharge and only 11 (58%) had received PT orders. Patients who were followed by PT in the hospital were significantly (p < .05) more likely to receive post-discharge PT. These data suggest that many elderly patients with physical disabilities at discharge do not receive PT during their hospita1 stay and that recognition of functional dependencies during a hospital stay is an important determinant of the use of post-discharge PT. Failure to recognize the presence of physical disability may be one factor explaining the low use of PT in elderly patients hospitalized for acute medical illness. More explicit criteria for the use of PT need to be established.

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