Home-Based Occupational Therapy and Stroke Readmissions in Medicaid Recipients

This study examined whether home-based occupational therapy reduces 30- and 90-day hospital readmissions post-stroke among Medicaid recipients. Using the Tennessee Medicaid data (2016-2023), adults ages 18 years and older with ischemic stroke were followed post-discharge. Logistic regression models examined associations between receiving home-based occupational therapy and readmissions. Of 3,393 patients, 19.6% were readmitted within 30 days; 27.3% within 90 days; 5.0% received home-based therapy within 30 days; and 7.9% within 90 days. Unadjusted analysis showed home-based occupational therapy was associated with lower 30-day readmissions (odds ratio [OR]: 0.57; 95% confidence interval [CI] = [0.36, 0.90]). Patients from suburban/rural areas showed increased readmission likelihood within 30 days compared with urban patients (adjusted odds ratio [AOR] = 1.28; 95% CI = [1.02, 1.60]). Adjusting for physical therapy and other covariates, the effect of occupational therapy was similar but non-significant (OR = 0.60; 95% CI = [0.23, 1.53]). Home-based occupational therapy services post-stroke may reduce hospital readmissions.