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Despite uniformity in occupational therapy licensure laws across the states, the ability to obtain and maintain licenses in multiple jurisdictions remains complicated and time consuming. This article explains the need for a licensure compact in the occupational therapy profession and describes the joint American Occupational Therapy Association (AOTA) and National Board for Certification in Occupational Therapy (NBCOT®) initiative to develop and implement the compact.

Introduction

This special issue reveals key insights to advance occupational therapy practice using health services research methodology.

Special Issue on Health Services Research and Occupational Therapy

A qualitative exploration of occupational therapists’ experiences in primary care found that participants perceived contributing to positive outcomes through working with patients on self-management, functional problem solving, and behavior change.

A systematic review of occupational therapy interventions for the prevention and reduction of falls found mixed strengths of evidence for common interventions.

The authors found evidence to support occupational therapy interventions that align with value-based measures in three outcome areas: functional status, medication reconciliation, and skin integrity.

In a review of EHR data, the authors found that although acute care occupational therapy utilization was driven partly by patient need, potential disparities in access to beneficial services may exist across sociodemographic characteristics and insurance type.

This review highlights the importance of preventable adverse events and the importance of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and control health care costs.

Analysis of 12-mo post–inpatient rehabilitation discharge interviews found a relationship between exercise and hospital readmission among patients with SCI; follow-up research is needed to determine whether regular exercise reduces hospital readmissions among this population.

The findings of this systematic review provide preliminary evidence for the economic effectiveness of occupational therapy in acute and subacute care.

Medical record review of patients who received acute occupational therapy services found that higher frequency of therapy was linked with lower odds of readmission.

Findings from a retrospective, case-control, cohort study reveal that occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses and point to a need for increased understanding of the intersectional factors that drive service delivery and disparities across the lifespan.

A retrospective study found no associations between acute self-care status, social support, or housing situation and 30-day readmission when all HRRP diagnoses were examined together; higher levels of independence with self-care were significantly associated with reduced odds of readmission for patients with pneumonia.

This scoping review maps the presence of occupational therapy’s domains and processes in the clinical practices that reduce hospital readmissions of older adults pursuing PAC services in SNFs.

Systematic Review

This systematic review found that additional occupational therapy interventions can be effective in reducing readmissions among some adult hospitalized patient populations, including those admitted for surgery or management of acute medical conditions; stronger evidence supports transitional care interventions.

Limited, moderate-quality evidence, primarily for interventions using cognitive and behavioral strategies, exists within the occupational therapy scope of practice for addressing depressive and anxiety symptoms within the physical disability IPR setting.

Research Articles

The findings of this study support the use of goniometry to measure scapular protraction and retraction in relation to occupational performance.

Brief Report

A review of electronic health records found that patients receiving occupational therapy services in the NCCU had a lower likelihood of community discharge; however, these findings may result from therapists’ consideration for the safest discharge location to ensure the greatest balance between independence and support.

The Issue Is . . .

This article illustrates the contribution of cost-effectiveness analysis in stroke rehabilitation using a hypothetical new intervention as an example.

The authors introduce the Learning Health System (LHS) concept and provide action steps for occupational therapy stakeholders to lay the foundation for LHSs in their own professional contexts.

Evidence-Based Practice

The authors describe a case report of an older adult recently diagnosed with Parkinson’s disease.

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