Faculty, Staff and Student Publications
Language
English
Publication Date
3-1-2026
Journal
Cancer Medicine
DOI
10.1002/cam4.71598
PMID
41858064
Abstract
Introduction: Occupational and physical therapy (OT/PT) referrals and utilization barriers for childhood cancer patients have not been adequately examined. The current study investigated factors influencing referrals to and utilization of OT/PT services among children with cancer at an NIH-designated cancer center.
Methods: This retrospective cohort study included pediatric cancer patients (up to 18.99 years) presenting to the center over a 33.5-month period. Variables that could influence referrals to OT/PT were extracted from the electronic medical record (EMR) including OT and PT referrals (inpatient and outpatient), OT and PT consult completion, age at diagnosis, cancer type, sex, race/ethnicity, insurance, cancer treatment, comorbidities, and social vulnerability index. Mixed-effect logistic regression models were applied.
Results: The cohort included 1080 patients (mean age 10.9 years; 55.1% male; 40.7% non-Hispanic White; 52.0% privately insured; 40.8% diagnosed with a non-neural solid tumor). Overall, 55.1% of inpatients and 22.5% of outpatients were referred for OT/PT, and 32.6% (93.6% of referrals) of inpatients and 13.7% (60.9% of referrals) of outpatients completed their OT/PT consults. Patients aged 18 to < 19 years at diagnosis had lower odds of inpatient OT/PT referral, and patients who underwent surgeries involving hardware placement or had conditions affecting mobility and function, pain, or cardiopulmonary diseases had higher odds of inpatient OT/PT referral. Compared with children with leukemia or lymphoma, children with central nervous system tumors had higher odds of outpatient OT/PT referral, and a non-neural solid tumor diagnosis was associated with greater odds of outpatient rehabilitation utilization.
Conclusion: Barriers to rehabilitation included age ≥ 18 years, outpatient setting, and leukemia diagnosis. More research is needed to identify strategies, such as using patient navigation and automated referrals, to improve utilization of OT/PT services for the pediatric cancer population.
Keywords
Humans, Male, Child, Female, Neoplasms, Adolescent, Retrospective Studies, Child, Preschool, Physical Therapy Modalities, Occupational Therapy, Referral and Consultation, Health Services Accessibility, Patient Acceptance of Health Care, Infant, cancer, child, occupational therapy, physical therapy, rehabilitation, survivor
Published Open-Access
yes
Recommended Citation
Swartz, Maria C; Zhang, Shiming; Kelly, Donna; et al., "Barriers to Occupational and Physical Therapy Utilization for Children With Cancer" (2026). Faculty, Staff and Student Publications. 6490.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6490
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