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Phys Ther. 2008 Aug;88(8):936-46. doi: 10.2522/ptj.20070308. Epub 2008 Jun 19.

Direct access to physical therapy in the Netherlands: results from the first year in community-based physical therapy.

Author information

1
Netherlands Institute for Health Services Research-Allied Health Care (NIVEL), PO Box 1568, 3500 BN, Utrecht, the Netherlands. C.Leemrijse@nivel.nl

Abstract

BACKGROUND:

In 2006, direct access to physical therapy was introduced in the Netherlands. Before this policy measure, evaluation and treatment by a physical therapist were only possible following referral by a physician.

OBJECTIVE:

The objectives of this study were to investigate how many patients use direct access and to establish whether these patients have a different profile than referred patients.

METHODS:

Electronic health care data from the National Information Service for Allied Health Care (LiPZ), a nationally representative registration network of 93 Dutch physical therapists working in 43 private practices, were used.

RESULTS:

In 2006, 28% of the patients seen by a physical therapist came by direct access. Patients with non-further-specified back problems, patients with nonspecific neck complaints, and higher-educated patients were more likely to refer themselves to a physical therapist, as were patients with health problems lasting for less than 1 month. Younger patients made more use of direct access. In addition, patients with recurring complaints more often referred themselves, as did patients who had received earlier treatment by a physical therapist. Patients with direct access received fewer treatment sessions. Compared with 2005, there was no increase in the number of patients visiting a physical therapist.

LIMITATIONS:

Data came only from physical therapists working on general conditions in general practices. Severity of complaints is not reported.

CONCLUSIONS:

A large, specific group of patients utilized self-referral, but the total number of patients seen by a physical therapist remained the same. In the future, it is important to evaluate the consequences of direct access, both on quality aspects and on cost-effectiveness.

PMID:
18566108
DOI:
10.2522/ptj.20070308
[Indexed for MEDLINE]
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