Beschreibung:
<jats:sec><jats:title>Objectives</jats:title><jats:p>To describe the proportion of residents receiving rehabilitation in long‐term care (<jats:styled-content style="fixed-case">LTC</jats:styled-content>) homes, and scores on activities of daily living (<jats:styled-content style="fixed-case">ADL</jats:styled-content>) and falls quality indicators (<jats:styled-content style="fixed-case">QI</jats:styled-content>s) before and after change from fee‐for‐service to an episode of care model; and to evaluate the effect of the change on the <jats:styled-content style="fixed-case">QI</jats:styled-content>s.</jats:p></jats:sec><jats:sec><jats:title>Data Sources</jats:title><jats:p>Secondary data were collected from all <jats:styled-content style="fixed-case">LTC</jats:styled-content> homes in Ontario, Canada, between January 1, 2011 and March 31, 2015. Variables of interest were the proportion of residents per home receiving physical therapy (<jats:styled-content style="fixed-case">PT</jats:styled-content>), and the scores on seven <jats:styled-content style="fixed-case">ADL</jats:styled-content> and one falls <jats:styled-content style="fixed-case">QI</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Retrospective, longitudinal study.</jats:p></jats:sec><jats:sec><jats:title>Data Extraction</jats:title><jats:p>All data were extracted from the Resident Assessment Instrument Minimum Data Set.</jats:p></jats:sec><jats:sec><jats:title>Principal Findings</jats:title><jats:p>Fewer residents received <jats:styled-content style="fixed-case">PT</jats:styled-content> after the policy change (84.6 percent, 2011; 56.6 percent, 2015). The policy change was associated with improved performance on several <jats:styled-content style="fixed-case">ADL QI</jats:styled-content>s. However, having a large proportion of residents receive no <jats:styled-content style="fixed-case">PT</jats:styled-content> or little <jats:styled-content style="fixed-case">PT</jats:styled-content> was associated with poorer performance on two of the <jats:styled-content style="fixed-case">QI</jats:styled-content>s measuring improvement in <jats:styled-content style="fixed-case">ADL</jats:styled-content>s [No <jats:styled-content style="fixed-case">PT</jats:styled-content>: −0.029 (−0.043 to −0.014); −0.048 (−0.068 to −0.027). <jats:styled-content style="fixed-case">PT</jats:styled-content> <45 minutes per week: −0.012 (−0.026 to −0.002); −0.026 (−0.045 to −0.007); <jats:italic>p</jats:italic> < .01].</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>While controversial, the policy and subsequent <jats:styled-content style="fixed-case">PT</jats:styled-content> service delivery change appears to be associated with improved performance on several <jats:styled-content style="fixed-case">ADL QI</jats:styled-content>s, except in homes where a large proportion of residents receive no <jats:styled-content style="fixed-case">PT</jats:styled-content> and low time‐intensive <jats:styled-content style="fixed-case">PT</jats:styled-content>.</jats:p></jats:sec>