A therapy-relevant casemix classification system for school-age children with disabilities

Objective: To develop a clinically meaningful classification system of reso urce-homogeneous groups to describe therapy resource use for school-age chi ldren with disabilities. Design: Work-time allocation survey of therapy services (physical therapist s, occupational therapists, and speech pathologists). Setting: Three main disability agencies in Western Australia. Clients: All children of two agencies, a random sample of children of the t hird. A total of 644 clients and their services were studied. Main Outcome Measurement: Minutes of therapy service time expected over a 1 0-week school term. Results: Forty-six percent of the variance in a measure of time spent with clients can be explained using a classification system of nine groups, base d on splitting a mobility measure (4 major groups), then the nature of prim ary disorder (2 subgroups), independence in self care (3 subgroups), and ex pressive communication (3 subgroups). Conclusion: This study defines a preliminary classification system for the distribution of therapy resources to school-age children with disabilities. This model has the potential to be used to purchase services on a fairer b asis than traditional, historical funding methods have allowed.