Direct access to physical therapy in the Netherlands: results from the first year in community-based physical therapy.
BACKGROUND
In 2006, direct access to physical therapy was introduced in the Netherlands. Before this policy measure, evaluation and treatment by a physical therapist were only possible following referral by a physician.


OBJECTIVE
The objectives of this study were to investigate how many patients use direct access and to establish whether these patients have a different profile than referred patients.


METHODS
Electronic health care data from the National Information Service for Allied Health Care (LiPZ), a nationally representative registration network of 93 Dutch physical therapists working in 43 private practices, were used.


RESULTS
In 2006, 28% of the patients seen by a physical therapist came by direct access. Patients with non-further-specified back problems, patients with nonspecific neck complaints, and higher-educated patients were more likely to refer themselves to a physical therapist, as were patients with health problems lasting for less than 1 month. Younger patients made more use of direct access. In addition, patients with recurring complaints more often referred themselves, as did patients who had received earlier treatment by a physical therapist. Patients with direct access received fewer treatment sessions. Compared with 2005, there was no increase in the number of patients visiting a physical therapist.


CONCLUSIONS
Data came only from physical therapists working on general conditions in general practices. Severity of complaints is not reported.


CONCLUSIONS
A large, specific group of patients utilized self-referral, but the total number of patients seen by a physical therapist remained the same. In the future, it is important to evaluate the consequences of direct access, both on quality aspects and on cost-effectiveness.
Netherlands Institute for Health Services Research-Allied Health Care (NIVEL), PO Box 1568, 3500 BN, Utrecht, the Netherlands. C.Leemrijse@nivel.nl
Chantal J
CJ
Leemrijse
Ilse C S
IC
Swinkels
Cindy
C
Veenhof
D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D026741:Physical Therapy Modalities; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012044:Regression Analysis