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En takstbasert analyse av avtalefysioterapeuters praksis
Engelsk titel: A reimbursement-based historical analysis of primary care physiotherapists practice in an evidence-based and financial perspective during 1984-2008 Läs online Författare: Bjordal, Jan Magnus ; Lygren, Hildegunn ; Naterstad, Ingvill Fjell ; Haslerud, Sturla ; Joensen, Jon Språk: Nor Antal referenser: 19 Dokumenttyp: Artikel UI-nummer: 14113792

Tidskrift

Fysioterapeuten 2014;81(9)38-45 ISSN 0016-3384 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

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.