The impact of outpatient rehabilitation services on physical function and potential risk of unplanned healthcare utilization.

e23142 Background: Unplanned healthcare use is associated with increased costs and poorer clinical outcomes, making it a critical target for oncology value-based care models. Poor physical function (PF) is an indicator of up to two-fold increased risk of unplanned healthcare use. Outpatient rehabilitation services are recommended to optimize PF, and as a result, could reduce risk of unplanned healthcare use. However, the paucity of data linking rehabilitation data with other health services data is a barrier to understanding the impact of rehabilitation on unplanned healthcare use. To approximate the impact of rehabilitation care, we compared PF scores of a large cohort seen in rehabilitation to the PF thresholds associated with increased risk of unplanned hospitalization. Methods: Rehabilitation medical record data was extracted for cases with breast, lung, colorectal, prostate, multiple myeloma, leukemia, and lymphoma who attended cancer rehabilitation 2022 to 2024, completed pre/post outcomes, and were identified as high risk for unplanned healthcare use at baseline (N = 1,185). High risk was identified as PROMIS-PF T-score < 35. Change in PF was examined using mixed-effect models adjusted for age, cancer type, surgery within two years, and time. Estimated marginal mean (EMM) change in PF was compared to the established minimal important change (MIC, 2 points). Unplanned healthcare risk reduction was determined as the proportion of cases with post-rehabilitation PF T-score above 35. Results: Cases were 63.91±12.75 years old, mostly female (78.1%) and 33.2% had received surgery in the past two years. Rehabilitation services were attended for a median of 8.72 weeks (IQR: 4.98 to 14.93). Common needs included: muscle weakness or atrophy (52.2%), limitations in daily activity or mobility (32.7%), pain (27.0%), lymphedema or edema (20.4%), musculoskeletal impairment or disorder (18.35%), fatigue (16.2%), and neuropathy (9.5%). PF scores improved significantly from pre- to post-rehabilitation ( p < .001). EMM change surpassed the MIC overall and for each diagnosis type (Table 1). Risk reduction ranged 42% (lung) to 72% (breast) by cancer type. Conclusions: PF improved significantly after rehabilitation, equating to 42% to 72% reduced risk of unplanned healthcare use by cancer type. By optimizing PF, integration of cancer rehabilitation services in value-based care models may reduce unplanned healthcare use. PF scores and estimated unplanned healthcare risk reduction. N Initial Final Change Estimated risk reduction Breast 725 31.14, 0.20 37.23, 0.20 6.09, 0.28 60.3% Colorectal 58 31.12, 0.73 37.97, 0.73 6.85, 1.01 72.4% Leukemia 52 28.56, 1.00 33.80, 1.00 5.23, 1.07 48.1% Lung 119 30.81, 0.58 35.42, 0.58 4.61, 0.65 42.0% Lymphoma 68 29.66, 0.89 35.17, 0.89 5.52, 0.87 50.0% Multiple myeloma 91 29.85, 0.74 36.27, 0.74 6.42, 0.75 59.3% Prostate 72 31.90, 1.24 37.44, 1.24 5.54, 0.97 59.7%

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Publication Details

Journal
Journal of Clinical Oncology
Published
2025-05-28
DOI
https://doi.org/10.1200/jco.2025.43.16_suppl.e23142
Primary Topic
Telemedicine and Telehealth Implementation
Type
article
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article

The impact of outpatient rehabilitation services on physical function and potential risk of unplanned healthcare utilization.

Kelley C. Wood, Mackenzi Pergolotti, Stacye Mayo
Journal of Clinical Oncology
Telemedicine and Telehealth Implementation
article

The impact of outpatient rehabilitation services on physical function and potential risk of unplanned healthcare utilization.

Kelley C. Wood, Mackenzi Pergolotti, Stacye Mayo
article en

Abstract

e23142 Background: Unplanned healthcare use is associated with increased costs and poorer clinical outcomes, making it a critical target for oncology value-based care models. Poor physical function (PF) is an indicator of up to two-fold increased risk of unplanned healthcare use. Outpatient rehabilitation services are recommended to optimize PF, and as a result, could reduce risk of unplanned healthcare use. However, the paucity of data linking rehabilitation data with other health services data is a barrier to understanding the impact of rehabilitation on unplanned healthcare use. To approximate the impact of rehabilitation care, we compared PF scores of a large cohort seen in rehabilitation to the PF thresholds associated with increased risk of unplanned hospitalization. Methods: Rehabilitation medical record data was extracted for cases with breast, lung, colorectal, prostate, multiple myeloma, leukemia, and lymphoma who attended cancer rehabilitation 2022 to 2024, completed pre/post outcomes, and were identified as high risk for unplanned healthcare use at baseline (N = 1,185). High risk was identified as PROMIS-PF T-score < 35. Change in PF was examined using mixed-effect models adjusted for age, cancer type, surgery within two years, and time. Estimated marginal mean (EMM) change in PF was compared to the established minimal important change (MIC, 2 points). Unplanned healthcare risk reduction was determined as the proportion of cases with post-rehabilitation PF T-score above 35. Results: Cases were 63.91±12.75 years old, mostly female (78.1%) and 33.2% had received surgery in the past two years. Rehabilitation services were attended for a median of 8.72 weeks (IQR: 4.98 to 14.93). Common needs included: muscle weakness or atrophy (52.2%), limitations in daily activity or mobility (32.7%), pain (27.0%), lymphedema or edema (20.4%), musculoskeletal impairment or disorder (18.35%), fatigue (16.2%), and neuropathy (9.5%). PF scores improved significantly from pre- to post-rehabilitation ( p < .001). EMM change surpassed the MIC overall and for each diagnosis type (Table 1). Risk reduction ranged 42% (lung) to 72% (breast) by cancer type. Conclusions: PF improved significantly after rehabilitation, equating to 42% to 72% reduced risk of unplanned healthcare use by cancer type. By optimizing PF, integration of cancer rehabilitation services in value-based care models may reduce unplanned healthcare use. PF scores and estimated unplanned healthcare risk reduction. N Initial Final Change Estimated risk reduction Breast 725 31.14, 0.20 37.23, 0.20 6.09, 0.28 60.3% Colorectal 58 31.12, 0.73 37.97, 0.73 6.85, 1.01 72.4% Leukemia 52 28.56, 1.00 33.80, 1.00 5.23, 1.07 48.1% Lung 119 30.81, 0.58 35.42, 0.58 4.61, 0.65 42.0% Lymphoma 68 29.66, 0.89 35.17, 0.89 5.52, 0.87 50.0% Multiple myeloma 91 29.85, 0.74 36.27, 0.74 6.42, 0.75 59.3% Prostate 72 31.90, 1.24 37.44, 1.24 5.54, 0.97 59.7%

Journal of Clinical OncologyVol. 43(16_suppl)
Openalex Percentile: Top 83%
Telemedicine and Telehealth Implementation
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