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Research Article  |   July 2003
Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?
Catherine L. Lysack; Stewart Neufeld
Author Affiliations
  • Catherine L. Lysack, PhD, OT(C), is Assistant Professor, Institute of Gerontology, 231 Knapp Building, 87 E. Ferry Street, Wayne State University, Detroit, Michigan 48202; c.lysack@wayne.edu. She is also Research Associate, Rehabilitation Institute of Michigan, Detroit, Michigan
  • Stewart Neufeld, PhD, is Assistant Professor, Institute of Gerontology, Wayne State University, Detroit, Michigan
Article Information
Advocacy / Home Accessibility/Environmental Modification / Professional Issues / Rehabilitation, Participation, and Disability / Assessment: Function and the Environment
Research Article   |   July 2003
Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?
American Journal of Occupational Therapy, July/August 2003, Vol. 57, 369-379. doi:10.5014/ajot.57.4.369
American Journal of Occupational Therapy, July/August 2003, Vol. 57, 369-379. doi:10.5014/ajot.57.4.369
Abstract

OBJECTIVE. The purpose of this study was (a) to describe the occupational therapy recommendations provided to patients discharged to inner city homes, and (b) to examine the relationship between patient health insurance and the number and type of occupational therapist recommendations for equipment and home modifications.

METHOD. An archival review was conducted of all referrals to the home evaluation program (n = 755) at a large urban rehabilitation hospital between January 1, 1994, and December 31, 1998. Additional patient demographic data and Functional Independence Measure (FIM) data were obtained in electronic form from the hospital information database.

RESULTS. Analysis of results showed that while the pattern of equipment and modification recommendations varied little, publicly insured patients received fewer home modification recommendations compared to privately insured patients (t = 3.7; p < .0005), and were discharged from rehabilitation with significantly lower functional independence (MANOVA F = 3.9; p = .05).

CONCLUSION. Results alert occupational therapists to the relationship between health insurance and treatment recommendations and point to patient advocacy and health policy as potential pathways to desired a achieve social change.