Referral patterns and utilization of physiotherapy services following a one-time physiotherapist consultation in general practice

The purpose of this study was to describe the influence of a one-time consultation of physiotherapists (PTs) by primary care physicians (PCPs) on utilization of physiotherapy services, functional outcomes, and number of treatment sessions per treatment episode. A 7-month observational study with 59 pairs of randomly selected PTs and PCPs was conducted, with a prospective follow-up study of patients being referred for physiotherapy (treatment) after the consultation. The main variables measured were: (1) characteristics of patients who were referred for physiotherapy after consultation compared to those who were not referred for physiotherapy after consultation; (2) number of sessions per treatment episode predicted by the consulting PT compared to the actual number; and (3) functional outcomes of physiotherapy. The primary study sample consisted of 352 patients referred for a one-time PT consultation. Of these patients 224 were referred for physiotherapy treatment after consultation. Patterns of referral for physiotherapy after consultation were positively related (p<0.05) with increased age, lower levels of education, longer duration of complaints, and a decrease in physical functioning in terms and number of impairments and disabilities. Functional outcomes were better than data of the national reference database of patients directly referred by PCPs for physiotherapy treatment. The mean number of sessions per treatment episode, including the one-time consultation, was lower (p<0.05).