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Effects of Direct Access Physical Therapy Intervention on Return Visits to Physical Therapy

1 August 2008

Abstract

Background: Kaiser Permanente has one of three well-established physical therapy primary care practice models, which is currently implemented in Northern California, Colorado, and in Group Heath. Kaiser Permanente Tualatin Medical Office has been utilizing direct access physical therapy continuously since 2007. Objective: To compare the number of follow-up physical therapy visits utilized by patients after an evaluation by a direct access physical therapist to those utilized by patients referred to physical therapy by a primary care provider. Study design: retrospective study design Methods and Measures: The study sample was comprised of 748 subjects, with 374 subjects seen in direct access physical therapy and 374 subjects evaluated after referral by a primary care provider. Results: Those subjects seen in the direct access physical therapy group had significantly fewer return visits averaging1.67±2.44 compared to 2.74±3.14 return visits when traditionally referred to physical therapy significance of p= 0.000. Subjects in the direct access group were significantly younger (p=0.000) than subjects in the traditionally referred group, 43.37±11.930 years and 48.04±11.959 years, respectively for those seen in direct access and 48.04±11.959 years for those seen in the traditionally referred physical therapy appointment. Limitations: Data from only one medical office facility within Kaiser Permanente was utilized in the study. Duration and severity of complaints, patient satisfaction, and functional outcomes were not reported. Conclusion: The number of return physical therapy visits was significantly reduced for those subjects that were evaluated in direct access physical therapy appointments compared to subjects that were traditionally referred to physical therapy.


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