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Effects of direct access to physiotherapy in The Netherlands in 2006.

Leemrijse, C. Effects of direct access to physiotherapy in The Netherlands in 2006. European Journal of Public Health: 2006, 16(Suppl. 1) 14. Abstract. 14 th Eupha conference "Politics, Policies and /or the Public's Health", Montreux, 16-18 November 2006.
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Background: Worldwide, physiotherapists, managers, politicians, and patients are debating on direct access to physiotherapy. In The Netherlands, patients have direct access to physiotherapy since January 2006. One of the reasons for introducing direct access is the growing workload of general practitioners and the increasing pressure on the access to primary health care. The aim of the present study was to investigate how many patients, for which health problems, make use of direct access to physiotherapy. Furthermore, it is examined whether this policy measure actually leads to a decline in visits to the general practitioner or merely to an increasing demand for physiotherapy. Methods: Data from the National Information Service for Allied Health Care (NISAHC) are used. NISAHC is an electronic registration network based on physiotherapists’ medical records in which about 100 physiotherapists, working in 40 private practices, participate. These therapists provide data on patients, referrals, health problems, and treatments. In November we expect to have data from January through August 2006. Results: Preliminary results from January through February 2006 reveal that nearly 25% (95% CI 17.8–28.5) of the patients visit the physiotherapist without a referral. These patients appear to be younger and higher educated than patients with a referral. Furthermore, direct-access patients more often have symptoms of the spine and the duration of their complaints is shorter. However, the total number of patients visiting the physiotherapist has not changed. Conclusions: The percentage of patients visiting the physiotherapists without a referral exceeds international data. Furthermore, a specific group of patients uses direct access. As the volume of the physiotherapists’ patient population has not grown, it seems that the demand for physiotherapy remains the same. This implies that general practitioners’ workload has declined.(aut. ref.)