Sammanfattning
Research question: Has primary care physiotherapists changed their pattern of reimbursement ,
and are these changes correlated to financial or scientific changes in reimbursement rates and
frequencies ?
Design: Longitudinal study with descriptive statistics analysis
Method: Historical development of reimbursement rates and their correlation with their respective
reimbursement frequencies.
Material: Historical data for reimbursement rates from 1988 to 2008, and reimbursement frequencies
from 1998 to 2008.
Results: This analysis shows that physical therapists examine less and deliver less individual
treatment than before. Nearly one in four patients is now treated in groups. Major changes (>20%) in
reimbursement rates were significantly associated with changes in clinical physiotherapy practice.
Regulatory intervention stopping overlap between patient treatments, resulted in fewer treatments
delivered per physiotherapist.
Conclusion: Primary care physiotherapists changed their practice to less individual examinations,
less individual and physical modality treatments towards increased use of group exercise
treatments. Major changes in reimbursement rates seemed to initiate shifts in treatment preferences.
Our data suggest an evolution of two distinctly different physiotherapist roles in primary care; the
autonomous examiner/therapist working on an individual patient/therapist basis, and the exercise
therapy group instructor. The physiotherapy profession may need to clarify what role future primary
care physiotherapists should possess.