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Reducing strain on primary healthcare systems through innovative models of care:the impact of direct access physiotherapy for musculoskeletal conditions—an interrupted time series analysis

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Family Medicine and Community Health 2024年第3期12卷 1-12页

作者： James Henry Zouch Bjørnar Berg are hugo pripp Kjersti Storheim Claire E Ashton-James Manuela L Ferreira Margreth Grotle Paulo H Ferreira Sydney Musculoskeletal Health Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia Centre for Intelligent Musculoskeletal Health Oslo Metropolitan University Faculty of Health SciencesOsloNorway Oslo Metropolitan University Faculty of Health Sciences OsloNorway Oslo Centre of Biostatistics and Epidemiology Oslo University HospitalOsloNorway Department of Rehabilitation Science and Health Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Department of Research and Innovation Oslo University Hospital Division of Clinical NeuroscienceOsloNorway Sydney Medical School Kolling InstituteThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia The George Institute for Global Health SydneyNew South WalesAustralia Department of Research and Innovation Oslo University HospitalOsloNorway Department of Rehabilitation and Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Charles Perkins Centre Sydney Musculoskeletal HealthThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia

Objectives To evaluate the longitudinal impact of introducing a national,direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal(MSK)*** Interrupted time series analysis using segmented linear *** Norway primary care Participants A cohort of 82072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in *** participants surveyed were eligible for inclusion as a national representative sample of the Norwegian *** MSK consultations were linked to the Norwegian Control and Payment of Health Reimbursement database and the Norwegian Patient Register using the International Classification of Primary Care diagnostic medical codes L-chapter for MSK conditions and spine related International Classification of Diseases,10th Revision,*** Direct access to physiotherapy model of care introduced nationally in Norway in *** model allowed Norwegians to consult directly with qualified physiotherapists for MSK conditions(eg,back pain,knee osteoarthritis)without the need for a medical referral in order to claim a social security *** outcomes measured Rates of primary care consultations per 10000 population(general practitioner(GP)and physiotherapist consultations)and secondary care(specialist consultations and surgical procedures)measured from 2014 to *** The introduction of the direct access physiotherapy model was associated with an immediate stepped reduction of 391 general practice consultations per 10000 population,(95%CI:−564 to−216),without an associated change in physiotherapy *** analyses suggested there was an associated reduction in physiotherapy consultations for those in the lowest education group of 150 consultations per quarter(95%CI:−203 to−97),70 consultations per quarter in the intermediate education group(95%CI:−115 to−27)and a step

关键词： impact analysis strain

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