title: Cost-Effectiveness of Physical Therapy Only and of Usual Care for Various Health Conditions: Systematic Review.
abstract: BACKGROUND
  Given continually rising health care costs, interventions of health care providers should be cost-effective.
  
  
  OBJECTIVE
  This review aimed to summarize current cost-effectiveness of physical therapy. Specific aims were: (1) to analyze cost-effectiveness of physical therapy only compared with usual care only, (2) to analyze cost-effectiveness of physical therapy added to usual care compared with usual care only, and (3) to specify in which health conditions physical therapy only or physical therapy added to usual care was cost-effective.
  
  
  METHODS
  Topic-related systematic reviews were searched in MEDLINE, CINAHL, PEDro, and Cochrane Library and manually.
  
  
  METHODS
  Studies published between 1998 and 2014 that investigated the cost-effectiveness of interventions carried out by physical therapists were reviewed. The methodological quality was assessed with the Cochrane risk of bias assessment for intervention studies and with the Quality of Health Economic Analyses Scale.
  
  
  METHODS
  Effectiveness and cost data for calculating incremental cost-effectiveness ratios (ICERs) and the original authors' conclusions were extracted.
  
  
  RESULTS
  The 18 included studies presented low risk of bias and contained 8 comparisons of physical therapy only with usual care only and 11 comparisons of physical therapy added to usual care with usual care only. Based on ICERs, physical therapy only or added to usual care was cost-effective in 9 out of the 19 comparisons and in 10 comparisons according to the original authors' conclusions.
  
  
  CONCLUSIONS
  Physical therapy only or added to usual care implies improved health in almost all studies. The cost-effectiveness of such interventions was demonstrated in half of the studies. This result might have been influenced by the fact that different definitions of the notion of "cost-effectiveness" exist.
authors.affiliation: E. Bürge, MPTSc, Health Department, University of Applied Sciences of Western Switzerland of Geneva, Geneva, Switzerland.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bürge
authors.affiliation: D. Monnin, PT, Care Services Directorate, University Hospitals and University of Geneva.
authors.forename: Dominique
authors.initials: D
authors.lastname: Monnin
authors.affiliation: A. Berchtold, PhD, University of Lausanne, Institute of Social Sciences and NCCR LIVES, Lausanne, Switzerland.
authors.forename: André
authors.initials: A
authors.lastname: Berchtold
authors.affiliation: L. Allet, PhD, University of Geneva, Medical Faculty, Department of Community Medicine, Geneva, Switzerland, and University of Applied Sciences of Western Switzerland, Geneva, Switzerland, Rue des Caroubiers 25, CH-1227 Carouge, Switzerland. lara.allet@hcuge.ch.
authors.forename: Lara
authors.initials: L
authors.lastname: Allet
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003863:Depression / Q000191:economics / Q000628:therapy; D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy; D009140:Musculoskeletal Diseases / Q000191:economics / Q000628:therapy*; D010300:Parkinson Disease / Q000191:economics / Q000628:therapy; D026741:Physical Therapy Modalities / Q000191:economics*; D014549:Urinary Incontinence / Q000191:economics / Q000628:therapy