Article

The Patient Protection and Affordable Care Act and the Health Care
and Education Reconciliation Act of 2010 contain provisions specific to health
care quality that apply to physical therapists. Published evidence examining gaps
in the quality of physical therapy services is limited. The primary
purpose of this study was to determine the use of quality indicators in physical
therapist practice. DESIGN:
This was an observational study. METHODS: All members
of the Orthopaedic and Private Practice sections of the American Physical Therapy
Association were invited to participate by completing an electronic survey. The
survey included 22 brief patient descriptions, each followed by questions
regarding the use of examinations and interventions based on the 2009 list of
Medicare-approved quality measures. Separate multivariate logistic regression
models were used to determine the odds ratios related to the performance of each
examination and intervention on more than 90% of patients, given perceptions of
its importance to care, the burden of performing it, and the level of evidence
supporting its use. RESULTS: Participants (n=2,544) reported a relatively low
frequency of performing examinations and interventions supporting primary and
secondary prevention (3.6%-51.3%) and use of standardized measures (5.5%-35.8%).
Perceptions of high importance and low burden were associated with greater odds
of performing an examination or intervention. Importance and burden were more
influential factors than the perceived availability of evidence to support use of
identified techniques. LIMITATIONS: The survey was not assessed for test-retest
reliability. A low response rate was a source of potential bias. CONCLUSION: The
study findings suggest that physical therapists may not see themselves as
providers of primary or secondary prevention services. Patient management
strategies associated with these types of services also may be perceived as
relatively unimportant or burdensome.

Langue : ANGLAIS