Article

Previous research suggested that physical therapy services can be
influenced by patient characteristics (age, sex, socioeconomic status) or
insurance status rather than their clinical need.
Objective: The aim of this
study was to determine whether patient-related factors
(age, sex, SES) and the
source of reimbursement for physical therapy services (insurance status)
influence wait time for, frequency of, and duration of physical therapy for low
back pain. Design: This study was an empirical cross-sectional online survey of
Canadian physical therapy professionals (defined as including physical therapists
and physical rehabilitation specialists). Methods: A total of 846 physical
therapy professionals received 1 of 24 different (and randomly selected) clinical
vignettes (ie, patient case scenarios) and completed a 40-item questionnaire
about how they would treat the fictional patient in the vignette as well as their
professional clinical practice. Each vignette described a patient with low back
pain but with variations in patient characteristics (age, sex, socioeconomic
status) and insurance status (no insurance, private insurance, Workers'
Compensation Board insurance). Results: The age, sex, and socioeconomic status of
the fictional vignette patients did not affect how participants would provide
service. However, vignette patients with Workers' Compensation Board insurance
would be seen more frequently than those with private insurance or no insurance.
When asked explicitly, study participants stated that insurance status, age, and
chronicity of the condition were not factors associated with wait time for,
frequency of, or duration of treatment. Limitations: This study used a
standardized vignette patient and may not accurately represent physical therapy
professionals' actual clinical practice. Conclusions: There appears to be an
implicit professional bias in relation to patients' insurance status; the
resulting inequity in service provision highlights the need for further research
as a basis for national guidelines to promote equity in access to and provision
of quality physical therapy services.

Langue : ANGLAIS