Direct access and self-referral to physical therapy (από την W.C.P.T.)
H άμεση πρόσβαση και η αυτο-παραπομπή σε Φυσικοθεραπεία είναι κλινικά και οικονομικά αποδοτική και με σημαντικά αποτελέσματα γιά ικανοποιημένους ασθενείς/πελάτες.
Μερικά βασικά στοιχεία :
1. Η άμεση πρόσβαση και η αυτο-παραπομπή κάνει υπεύθυνους τους ασθενείς/πελάτες για τον έλεγχο της φροντίδας τους.
2. Οι ασθενείς/πελάτες οι οποίοι επιθυμούν Φυσικοθεραπεία:
- είναι πιο ενεργοί
- είναι πιο αυτόνομοι στη λήψη αποφάσεων για την υγεία τους
- θα χρειαστούν λιγότερο χρόνο αποχής από την εργασία
- θα επιστρέψουν στην εργασία τους νωρίτερα
- έχουν περισσότερες πιθανότητες να ολοκληρώσουν την πορεία της θεραπείας τους
- ενδιαφέρονται περισσότερο για την αυτο-διαχείριση του προβλήματός τους και
- είναι πιο ικανοποιημένοι από τις υπηρεσίες που λαμβάνουν.
Η άμεση πρόσβαση και η αυτο-παραπομπή εξοικονομούν χρήματα στο σύστημα υγείας, αλλά και στον ενδιαφερόμενο, μέσω :
- της μείωσης του κόστους από τις επισκέψεις σε άλλους επαγγελματίες υγείας, π.χ. γενικούς, οικογενειακούς και άλλων ειδικοτήτων γιατρούς
- λιγότερης συνταγογράφησης
- λιγότερων διαγνωστικών εξετάσεων
- λιγότερων παραπομπών σε δευτεροβάθμια περίθαλψη
- της μείωσης του κόστους για την κοινωνία, πχ μικρότερη αποχή από την εργασία και
- λιγότερων εξόδων διοίκησης για το ασφαλιστικό σύστημα.
Η άμεση πρόσβαση και η αυτο-παραπομπή δεν θα οδηγήσει σε αύξηση της ζήτησης για υπηρεσίες, ακόμη και αν είναι επαρκείς οι πόροι του συστήματος.
Η άμεση πρόσβαση και την αυτο-παραπομπή δεν είναι κατάλληλες μόνο για μυοσκελετικά προβλήματα, αλλά για όλους τους τομείς της Φυσικοθεραπευτικής πρακτικής.
Η έρευνα μέχρι σήμερα έχει επικεντρωθεί στις μυοσκελετικές παθήσεις.
Κατάλογος αναφοράς:
Οι παρακάτω αναφορές παρέχουν απόδειξη της κλινικής και της αποτελεσματικότητας της άμεσης πρόσβασης και της αυτο-παραπομπής σε υπηρεσίες Φυσικοθεραπείας, καθώς και το πολιτικό και επαγγελματικό πλαίσιο εφαρμογής τους:
Anon. Self-referral media hit. Physiotherapy Frontline 2008;14(19): 7-7.
Boyce RA. Direct access physiotherapy in Australia. Letter in response to article:
Holdsworth LK, Webster VS. Direct access to physiotherapy in primary care: now? – and
into the future? Physiotherapy 2004;90:64-72. Physiotherapy 2005;91(1):61-62.
Bury TJ, Stokes EK. A Global View of Direct Access and Patient Self-Referral to Physical
Therapy: Implications for the Profession. Physical Therapy 2013;93(4):449-459; published
ahead of print November 29, 2012, doi:10.2522/ptj.20120060 [open access]
Bury TJ, Stokes EK. Direct access and patient/client self-referral to physiotherapy: a review
of contemporary practice within the European Union. Physiotherapy In Press 2013,
published online ahead of print: http://dx.doi.org/10.1016/j.physio.2012.12.011 [open
access for 3 months]
Clews G. Pelvic health self-referral takes off. Physiotherapy Frontline 2007;13(23):8-9.
Crout K, Tweedie J, Miller D. Physical therapists' opinions and practices regarding direct
access. Physical Therapy 1998;78:52-61.
Department of Health. Self-referral pilots to musculoskeletal physiotherapy and the
implications for improving access to other AHP services. Department of Health; London,
UK; 2008.
Domholdt E, Durchholz AG. Direct access use by experienced therapists in states with
direct access. Physical Therapy 1992;72(8):569.
Domholdt E, Lord L, LeMasters A, Durant T. Direct access: a hypothetical debate. Clin
Manag Phys Ther 1989;9(2):33
Durant TL, Lord LJ, Domholdt E. Outpatient views on direct access to physical therapy in
Indiana. Physical Therapy 1989;69(10):850.
Ferguson A, Griffin E, Mulcahy C. Patient self-referral to physiotherapy in general practice -
a model for the new NHS? Physiotherapy 1999;85(1):13.
Flynn TW. Direct access: the time has come for action. Journal of Orthopaedic and Sports
Physical Therapy 2003;33(3):102.
Fordham R, Hodkinson C. A Cost Benefit Analysis of Open Access to Physiotherapy for
GPs: Discussion Paper 29. York, UK: Centre for Health Economics Health Economics
Consortium. University of York; 1998
Galley P. Ethical principles and patient referral. Australian Journal of Physiotherapy
1975;21(3):97-100.
http://ajp.physiotherapy.asn.au/AJP/vol_21/3/AustJPhysiotherv21i3Galley2.pdf
Galley P. Patient referral and the physiotherapist. Australian Journal of Physiotherapy
1976;22(3):117-120.
http://ajp.physiotherapy.asn.au/AJP/vol_22/3/AustJPhysiotherv22i3Galley.pdf
Galley P. Physiotherapists as first-contact practitioners--New challenges and
responsibilities in Australia. Physiotherapy 1977;63(8):246-248.
Holdsworth LK, Webster VS. Direct access to physiotherapy in primary care: now? -- and
into the future? Physiotherapy 2004;90(2):64-72.
Holdsworth LK, Webster, VS and McFadyen, AK. Are patients who refer themselves to
physiotherapy different from those referred by GPs? Results of a national
trial. Physiotherapy 2006;92(1):26-33.
Holdsworth LK, Webster, VS and McFadyen, AK. Physiotherapists' and general
practitioners' views of self-referral and physiotherapy scope of practice: results from a
national trial. Physiotherapy 2008;94(3):236-243.
Holdsworth LK, Webster, VS and McFadyen, AK. Self-referral to physiotherapy: deprivation
and geographical setting: is there a relationship? Results of a national
trial. Physiotherapy 2006;92(1):16-25.
Holdsworth LK, Webster, VS and McFadyen, AK. What are the costs to NHS Scotland of
self-referral to physiotherapy? Results of a national trial. Physiotherapy 2007;93(1):3-11.
Jones C, Cutner, A and Goldingay, J. Easier access to physiotherapy for stress urinary
incontinence and prolapse: does it improve compliance? Journal of the Association of
Chartered Physiotherapists in Women's Health 2007;101:44-47.
Kruger J. Patient referral and the physiotherapist: three decades later. Australian Journal of
Physiotherapy 2010;56:217-218.
Leemrijse CJ, Swinkels ICS, Pisters MF, de Bakker D, Veenhof C. Direct access to
physiotherapy: the patients' choice [Dutch]. Nederlands Tijdschrift Voor Fysiotherapie.
2008;118(3):62-67.
Leemrijse CJ, Swinkels, ICS and Veenhof, C. Direct Access to Physical Therapy in the
Netherlands: Results From the First Year in Community-Based Physical Therapy. Physical
Therapy 2008;88(8):936-946.
Massey BF. 2002 APTA Presidential Address: What's all the fuss about direct access?
Physical Therapy. 2002;82(11):1120.
McCallum C, DiAngelis T. Direct Access: Factors that affect physical therapist practice in
the State of Ohio. Physical Therapy. 2012;92(5)688-706.
Mitchell JM and de Lissovoy, G. A comparison of resource use and cost in direct access
versus physician referral episodes of physical therapy. Physical Therapy 1997;77(11):10-
18.
Moore J. Vision in action: Direct access. Physical Therapy Magazine 2001;9(2):77-79.
http://mptac.missouri.org/DirectAccessPTmag.pdf
Obajuluwaa V, Abereojeb, O and Olaogunc , M. First-contact physiotherapy practice in
Nigeria. Physiotherapy Theory and Practice 1990;6(2):85-89.
Ojha HA, Snyder RS and Davenport TE. Direct access compared with referred physical
therapy episodes of care: a systematic review. Physical Therapy 2013 published online
before print doi: 10.2522/ptj.20130096
http://ptjournal.apta.org/content/early/2013/10/17/ptj.20130096.abstract
Oxlade L and Wilde, L. Successful self-referral service empowers patients. Physiotherapy
Frontline 2003;9(22):13-13.
Pendergast J, Kliethermes SA, Freburger JK, Duffy PA. Comparison of Health Care Use for
Physician-Referred and Self-Referred Episodes of Outpatient Physical Therapy. Health
Services Research 2012;47(2):633-54.
Rose SJ. Direct Access: The Need for an Educational Component. Physical Therapy
1988;68(9):1329.
Salisbury C, Montgomery AA, Hollinghurst S, Hopper C, Bishop A, Franchini A, Kaur S,
Coast J, Hall J, Grove S, Foster NE. Effectiveness of PhysioDirect telephone assessment
and advice services for patients with musculoskeletal problems: pragmatic randomised
controlled trial. BMJ 2013;Jan 29;346:f43. doi: 10.1136/bmj.f43.
Saporta A, Gibson BE. Ethics of self-referral for profit: case example of a physician-owned
physiotherapy clinic. Physiotherapy Canada 2007;59(4):266-271.
Shoemaker M. Direct Consumer Access to Physical Therapy in Michigan: Challenges to
Policy Adoption. Physical Therapy 2012;92(2):236-250.
Swinkels ICS, Leemrijse, CJ and Veenhof, C. One year of direct access to physiotherapy
[Dutch]. Nederlands Tijdschrift Voor Fysiotherapie 2007;117(5):158-165.
Taylor TK and Domholdt, E. Legislative change to permit direct access to physical therapy
services: A study of process and content issues. Physical Therapy 1991;71(5):382-389.
http://www.ptjournal.org/cgi/reprint/71/5/382
Tepper DE. Reimbursement victories: direct access and others. Physical Therapy
Magazine 2003;11(3):42.
Turner D. An exploratory study of physiotherapy telephone assessment... Including
commentary by Foster NE. International Journal of Therapy & Rehabilitation 2009;16(2):97-
105.
Webster VS, Holdsworth LK, McFadyen, Little H. Self-referral, access and physiotherapy:
patients' knowledge and attitudes. Results of a national trial. Physiotherapy
2008;94(2):141.
World Confederation for Physical Therapy. Policy statement: Direct access and
patient/client self-referral to physical therapy. London, UK: WCPT; 2011.
Boyce RA. Direct access physiotherapy in Australia. Letter in response to article:
Holdsworth LK, Webster VS. Direct access to physiotherapy in primary care: now? – and
into the future? Physiotherapy 2004;90:64-72. Physiotherapy 2005;91(1):61-62.
Bury TJ, Stokes EK. A Global View of Direct Access and Patient Self-Referral to Physical
Therapy: Implications for the Profession. Physical Therapy 2013;93(4):449-459; published
ahead of print November 29, 2012, doi:10.2522/ptj.20120060 [open access]
Bury TJ, Stokes EK. Direct access and patient/client self-referral to physiotherapy: a review
of contemporary practice within the European Union. Physiotherapy In Press 2013,
published online ahead of print: http://dx.doi.org/10.1016/j.physio.2012.12.011 [open
access for 3 months]
Clews G. Pelvic health self-referral takes off. Physiotherapy Frontline 2007;13(23):8-9.
Crout K, Tweedie J, Miller D. Physical therapists' opinions and practices regarding direct
access. Physical Therapy 1998;78:52-61.
Department of Health. Self-referral pilots to musculoskeletal physiotherapy and the
implications for improving access to other AHP services. Department of Health; London,
UK; 2008.
Domholdt E, Durchholz AG. Direct access use by experienced therapists in states with
direct access. Physical Therapy 1992;72(8):569.
Domholdt E, Lord L, LeMasters A, Durant T. Direct access: a hypothetical debate. Clin
Manag Phys Ther 1989;9(2):33
Durant TL, Lord LJ, Domholdt E. Outpatient views on direct access to physical therapy in
Indiana. Physical Therapy 1989;69(10):850.
Ferguson A, Griffin E, Mulcahy C. Patient self-referral to physiotherapy in general practice -
a model for the new NHS? Physiotherapy 1999;85(1):13.
Flynn TW. Direct access: the time has come for action. Journal of Orthopaedic and Sports
Physical Therapy 2003;33(3):102.
Fordham R, Hodkinson C. A Cost Benefit Analysis of Open Access to Physiotherapy for
GPs: Discussion Paper 29. York, UK: Centre for Health Economics Health Economics
Consortium. University of York; 1998
Galley P. Ethical principles and patient referral. Australian Journal of Physiotherapy
1975;21(3):97-100.
http://ajp.physiotherapy.asn.au/AJP/vol_21/3/AustJPhysiotherv21i3Galley2.pdf
Galley P. Patient referral and the physiotherapist. Australian Journal of Physiotherapy
1976;22(3):117-120.
http://ajp.physiotherapy.asn.au/AJP/vol_22/3/AustJPhysiotherv22i3Galley.pdf
Galley P. Physiotherapists as first-contact practitioners--New challenges and
responsibilities in Australia. Physiotherapy 1977;63(8):246-248.
Holdsworth LK, Webster VS. Direct access to physiotherapy in primary care: now? -- and
into the future? Physiotherapy 2004;90(2):64-72.
Holdsworth LK, Webster, VS and McFadyen, AK. Are patients who refer themselves to
physiotherapy different from those referred by GPs? Results of a national
trial. Physiotherapy 2006;92(1):26-33.
Holdsworth LK, Webster, VS and McFadyen, AK. Physiotherapists' and general
practitioners' views of self-referral and physiotherapy scope of practice: results from a
national trial. Physiotherapy 2008;94(3):236-243.
Holdsworth LK, Webster, VS and McFadyen, AK. Self-referral to physiotherapy: deprivation
and geographical setting: is there a relationship? Results of a national
trial. Physiotherapy 2006;92(1):16-25.
Holdsworth LK, Webster, VS and McFadyen, AK. What are the costs to NHS Scotland of
self-referral to physiotherapy? Results of a national trial. Physiotherapy 2007;93(1):3-11.
Jones C, Cutner, A and Goldingay, J. Easier access to physiotherapy for stress urinary
incontinence and prolapse: does it improve compliance? Journal of the Association of
Chartered Physiotherapists in Women's Health 2007;101:44-47.
Kruger J. Patient referral and the physiotherapist: three decades later. Australian Journal of
Physiotherapy 2010;56:217-218.
Leemrijse CJ, Swinkels ICS, Pisters MF, de Bakker D, Veenhof C. Direct access to
physiotherapy: the patients' choice [Dutch]. Nederlands Tijdschrift Voor Fysiotherapie.
2008;118(3):62-67.
Leemrijse CJ, Swinkels, ICS and Veenhof, C. Direct Access to Physical Therapy in the
Netherlands: Results From the First Year in Community-Based Physical Therapy. Physical
Therapy 2008;88(8):936-946.
Massey BF. 2002 APTA Presidential Address: What's all the fuss about direct access?
Physical Therapy. 2002;82(11):1120.
McCallum C, DiAngelis T. Direct Access: Factors that affect physical therapist practice in
the State of Ohio. Physical Therapy. 2012;92(5)688-706.
Mitchell JM and de Lissovoy, G. A comparison of resource use and cost in direct access
versus physician referral episodes of physical therapy. Physical Therapy 1997;77(11):10-
18.
Moore J. Vision in action: Direct access. Physical Therapy Magazine 2001;9(2):77-79.
http://mptac.missouri.org/DirectAccessPTmag.pdf
Obajuluwaa V, Abereojeb, O and Olaogunc , M. First-contact physiotherapy practice in
Nigeria. Physiotherapy Theory and Practice 1990;6(2):85-89.
Ojha HA, Snyder RS and Davenport TE. Direct access compared with referred physical
therapy episodes of care: a systematic review. Physical Therapy 2013 published online
before print doi: 10.2522/ptj.20130096
http://ptjournal.apta.org/content/early/2013/10/17/ptj.20130096.abstract
Oxlade L and Wilde, L. Successful self-referral service empowers patients. Physiotherapy
Frontline 2003;9(22):13-13.
Pendergast J, Kliethermes SA, Freburger JK, Duffy PA. Comparison of Health Care Use for
Physician-Referred and Self-Referred Episodes of Outpatient Physical Therapy. Health
Services Research 2012;47(2):633-54.
Rose SJ. Direct Access: The Need for an Educational Component. Physical Therapy
1988;68(9):1329.
Salisbury C, Montgomery AA, Hollinghurst S, Hopper C, Bishop A, Franchini A, Kaur S,
Coast J, Hall J, Grove S, Foster NE. Effectiveness of PhysioDirect telephone assessment
and advice services for patients with musculoskeletal problems: pragmatic randomised
controlled trial. BMJ 2013;Jan 29;346:f43. doi: 10.1136/bmj.f43.
Saporta A, Gibson BE. Ethics of self-referral for profit: case example of a physician-owned
physiotherapy clinic. Physiotherapy Canada 2007;59(4):266-271.
Shoemaker M. Direct Consumer Access to Physical Therapy in Michigan: Challenges to
Policy Adoption. Physical Therapy 2012;92(2):236-250.
Swinkels ICS, Leemrijse, CJ and Veenhof, C. One year of direct access to physiotherapy
[Dutch]. Nederlands Tijdschrift Voor Fysiotherapie 2007;117(5):158-165.
Taylor TK and Domholdt, E. Legislative change to permit direct access to physical therapy
services: A study of process and content issues. Physical Therapy 1991;71(5):382-389.
http://www.ptjournal.org/cgi/reprint/71/5/382
Tepper DE. Reimbursement victories: direct access and others. Physical Therapy
Magazine 2003;11(3):42.
Turner D. An exploratory study of physiotherapy telephone assessment... Including
commentary by Foster NE. International Journal of Therapy & Rehabilitation 2009;16(2):97-
105.
Webster VS, Holdsworth LK, McFadyen, Little H. Self-referral, access and physiotherapy:
patients' knowledge and attitudes. Results of a national trial. Physiotherapy
2008;94(2):141.
World Confederation for Physical Therapy. Policy statement: Direct access and
patient/client self-referral to physical therapy. London, UK: WCPT; 2011.