title: Access to publicly funded outpatient physiotherapy services in Quebec: waiting lists and management strategies.
abstract: OBJECTIVE
  Problems with access to outpatient physiotherapy services have been reported in publicly funded healthcare systems worldwide. A few studies have reported management strategies aimed at reducing extensive waiting lists, but their association with waiting times is not fully understood. The purpose of this study was to document access to public outpatient physiotherapy services for persons with musculoskeletal disorders in hospitals and explore organizational factors associated with waiting time.
  
  
  METHODS
  We surveyed outpatient physiotherapy services in publicly funded hospitals in the province of Quebec (Canada).
  
  
  RESULTS
  A total of 97 sites responded (99%) to the survey. The median waiting time was more than six months for 41% of outpatient physiotherapy services. The waiting time management strategies most frequently used were attendance and cancelation policies (99.0%) and referral prioritization (95.9%). Based on multivariate analyses, the use of a prioritization process with an initial evaluation and intervention was associated with shorter waiting times (p = 0.008).
  
  
  CONCLUSIONS
  Our findings provide evidence that a large number of persons wait a long time for publicly funded physiotherapy services in Quebec. Based on our results, implementation of a prioritization process with an initial evaluation and intervention could help improve timely access to outpatient physiotherapy services. Implications for Rehabilitation Access to publicly funded outpatient physiotherapy services is limited by long waiting times in a great proportion of Quebec's hospitals. The use of a specific prioritization process that combines an evaluation and an intervention could possibly help improve timely access to services. Policy-makers, managers, and other stakeholders should work together to address the issue of limited access to publicly funded outpatient physiotherapy services.
authors.affiliation: a Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) , Quebec City , Quebec , Canada.|b Department of Rehabilitation, Faculty of Medicine , Université Laval , Quebec City , Quebec , Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Deslauriers
authors.affiliation: c School of Rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Quebec , Canada.|d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montreal , Quebec , Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Raymond
authors.affiliation: c School of Rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Quebec , Canada.|d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montreal , Quebec , Canada.
authors.forename: Maude
authors.initials: M
authors.lastname: Laliberté
authors.affiliation: a Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) , Quebec City , Quebec , Canada.|b Department of Rehabilitation, Faculty of Medicine , Université Laval , Quebec City , Quebec , Canada.
authors.forename: Amélie
authors.initials: A
authors.lastname: Lavoie
authors.affiliation: c School of Rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Quebec , Canada.|e Maisonneuve-Rosemont Hospital Research Centre , Montreal , Quebec , Canada.
authors.forename: François
authors.initials: F
authors.lastname: Desmeules
authors.affiliation: c School of Rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Quebec , Canada.|d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montreal , Quebec , Canada.|f Direction of Public Health of the Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'ḽle-de-Montréal , Montreal , Quebec , Canada.
authors.forename: Debbie E
authors.initials: DE
authors.lastname: Feldman
authors.affiliation: a Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) , Quebec City , Quebec , Canada.|b Department of Rehabilitation, Faculty of Medicine , Université Laval , Quebec City , Quebec , Canada.
authors.forename: Kadija
authors.initials: K
authors.lastname: Perreault
mesh_terms: D000553:Ambulatory Care; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011792:Quebec; D014850:Waiting Lists
keywords: Outpatient physiotherapy; access; publicly funded health sector; waiting list; waiting time management strategies