Het gebruik van kinesitherapie en van fysische geneeskunde ... - KCE

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80 Physiotherapy & Physical and Rehabilitation Medicine KCE Reports 87 4.5.2.2 Choice of beginning with PRM when the first course of rehabilitation treatment is received during hospitalisation Model building based on patient characteristics A model only taking account of patient characteristics is not satisfactory. Its predictive power (0.67) is little better than chance (where probability of prediction = 0.5). The parameters below increase the chances that the patient will receive PRM instead of PT as first intention treatment: • No minor risk entitlements (no rights to all interventions of compulsory health insurance that is outpatient PT) makes these patients 25 times more likely to receive PRM first. • Having PRM within the 30 day-period before the operation makes these patients 4 times more likely to receive PRM first. • Poor vital prognosis (patients dying the year following the operation) makes these patients 1.5 times more likely to receive PRM first. • Rehabilitation during hospitalisation only makes these patients 1.6 times more likely to receive PRM first. The type of surgical procedure also plays a role. Among surgical procedures, only fractures of the tibia and, to a lesser extent, procedures on the shoulder and the upper arm, have a greater odd ratio y than hip prostheses (exhibiting the highest percentage of first intention PRM). For all other procedures, compared to hip prosthesis, the probability of receiving PRM is lower, e.g. for mastectomy, hallux valgus and incontinence. Other parameters are significant but do not greatly increase the chances of receiving PRM rehabilitation as first treatment: • Socio-economic status (income level, unemployment rate in the statistical quarter of residence, entitlement to attendance allowance); • Patient health status (proxy ASA); • Patient dependency: nursing home resident, work disability, “proxy ASA”, MAF entitlement; • Age and gender. Table 31 : Probability of beginning rehabilitation with PRM versus PT based on patient socio-health characteristics Effect DF WaldChi-square Pr > ChiSq Minor risk entitlements 1 497.3626
KCE Reports 87 Physiotherapy & Physical and Rehabilitation Medicine 81 Table 32 : Probability of beginning rehabilitation with PRM versus PT based on patient socio-health characteristics: odds ratio Analysis of Maximum Likelihood Estimates 95% Wald Esti- Pr Odds Confidence Parameter mate > ChiSq ratio Limits Intercept -0.3218 0.0019 0.725 Minor risk entitlements No vs yes 3.2426
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Het gebruik van kinesitherapie en van fysische geneeskunde ... - KCE

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