Application of a Biopsychosocial Framework to Identify Prognostics Factors of Patients Most Likely to Self-discharge from Physical Therapy Early on in the Plan of Care

Tuesday, October 28, 2025

4:15 PM - 4:30 PM

Location: ROOM: Continental C Ballroom >>> DIRECTIONS: Lobby Level >>> From the Main Elevator Bank, proceed right toward the FedEx Office. Continue past ACRM Registration and into the Continental Foyer. Continental C Lobby is located near the far end of the ballroom complex.

Presenting Author(s)

Tim F. Marshall, PhD, MHA, MS

Senior Director, Analytics & Insights
Ivy Rehab Network
Hazlet, NJ, United States
Thomas Agrusti, MPH, CPH

Statistician
Ivy Rehab Network
White Plains, NY, United States

Non-presenting Author(s)

CH

Chase Hendley, n/a

Data Scientist
Ivy Rehab Network
Longmont, Colorado, United States

Presenting Author(s)

Christopher G. Bise, PT, DPT, PhD

Assistant Professor
University of Pittsburgh
Pittsburgh, PA, United States

Slides Slides

This presentation explores the critical factors influencing patient retention and self-discharge in physical therapy, highlighting the significant protective role of manual therapy delivered during the initial evaluation visit. It emphasizes that initiating meaningful treatment early increases the likelihood of patients returning for subsequent sessions. The discussion addresses the varying impact of active, manual, and passive therapies, noting passive therapies’ limited use but valuable adjunctive role. Additionally, the presentation uncovers how socioeconomic factors, such as patients' financial capacity, affect therapy adherence, with higher-paying patients showing lower self-discharge rates. Finally, it underscores the additive and dose-dependent protective effects of different therapy forms, providing insights for clinicians to optimize treatment plans and patient engagement to improve therapy completion and outcomes. The findings offer a foundation for further research into tailored intervention dosing and highlight the importance of addressing both clinical and socioeconomic barriers to patient retention.

Learning Objectives:

List common psychosocial factors that are common amongst patients who are more likely to self-discharge early from their physical therapy plan of care
Articulate the importance of using a biopsychosocial framework for understanding patient behavior
Identify tools to assess psychosocial factors
Identify patients who demonstrate risk factors associated with self-discharge from their physical therapy plan of care.