Happy 5th BDay to my fav early morning coffee shop, @dojocoffee. Free small coffee with any purchase in celebration.
252 days ago
RT @MariahGardner: If you want the world to make a little bit of sense, sometimes you just have to presume that people are off their meds.
255 days ago
@ImTheQ Top news story in Memphis: "Man calls 911, demands tacos" No doubt
255 days ago
We have established that one of the main barriers to direct access is the issue of third party reimbursement for physical therapy delivered via direct access. It is difficult to judge the true nature of the benefit or demand of direct access services when they are not being fairly offered (assuming a professional should be paid for delivering services consistent with their practice act is fair!). Well, a handy situation presented itself in the Netherlands in 2006 and researchers took advantage of it.
The Netherlands decided to implement direct access services in 2006 as part of a larger health care reform which focused on improving the role and ability of patients to choose the appropriate health providers. Most Dutch insurers reimburse for direct access services. In addition, patient data was entered into a national database, enabling researchers to examine patient outcomes, demographics, and care patterns during the fist year of direct access implementation.
Several interesting findings came to the surface. By December of 2006, 32% of patients were seen via direct access, following a steadily increasing trend. Low back pain of non-specific nature and neck pain were the most common reason for self-referral to a physical therapist. The patients utilizing direct access seemed to be younger, more educated, and have an onset of problems of less than one month. Interestingly, the overall number of patients seen by physical therapist did not increase, indicating that fears of over-utilization might be unfounded.
But, what matters most is outcomes, and the data supports improved outcomes in this study as well. On average, patients being seen by direct access recieved fewer visits and were more likely to be discharged because their goals were achieved than those patients referred by a physician to physical therapy.
What's really interesting about this study is that it's like a little market research product bundled into the form of a scholarly paper. It identifies a target audience, indicates demand, and provides defense of the product's ability to create a benefit to the healthcare community. Still, 32% is still a low-ish level of utilization and it would be nice to see how these numbers change over the next few years as patients got more familiar with direct access.
There might be some really strong evidence to explore concerning the fact that early access to physical therapist for musculoskeletal conditions results in much improved outcomes and a strong cost : benefit ratio. When that evidence becomes clear is when insurers here in the US will have to take a closer look at their restrictive reimbursement policies!
C. J Leemrijse, I. C. Swinkels, C. Veenhof (2008). Direct Access to Physical Therapy in the Netherlands: Results From the First Year in Community-Based Physical Therapy Physical Therapy DOI: 10.2522/ptj.20070308
We have established that one of the main barriers to direct access is the issue of third party reimbursement for physical therapy delivered via direct access. It is difficult to judge the true nature of the benefit or demand of direct access services when they are not being fairly offered (assuming a professional should be paid for delivering services consistent with their practice act is fair!). Well, a handy situation presented itself in the Netherlands in 2006 and researchers took advantage of it.
The Netherlands decided to implement direct access services in 2006 as part of a larger health care reform which focused on improving the role and ability of patients to choose the appropriate health providers. Most Dutch insurers reimburse for direct access services. In addition, patient data was entered into a national database, enabling researchers to examine patient outcomes, demographics, and care patterns during the fist year of direct access implementation.
But, what matters most is outcomes, and the data supports improved outcomes in this study as well. On average, patients being seen by direct access recieved fewer visits and were more likely to be discharged because their goals were achieved than those patients referred by a physician to physical therapy.
What's really interesting about this study is that it's like a little market research product bundled into the form of a scholarly paper. It identifies a target audience, indicates demand, and provides defense of the product's ability to create a benefit to the healthcare community. Still, 32% is still a low-ish level of utilization and it would be nice to see how these numbers change over the next few years as patients got more familiar with direct access.
There might be some really strong evidence to explore concerning the fact that early access to physical therapist for musculoskeletal conditions results in much improved outcomes and a strong cost : benefit ratio. When that evidence becomes clear is when insurers here in the US will have to take a closer look at their restrictive reimbursement policies!
C. J Leemrijse, I. C. Swinkels, C. Veenhof (2008). Direct Access to Physical Therapy in the Netherlands: Results From the First Year in Community-Based Physical Therapy Physical Therapy DOI: 10.2522/ptj.20070308