Direct access and patient/client self-referral to physiotherapy: a review of contemporary practice within the European Union
Direct access and patient/client self-referral to physiotherapy: a review of contemporary practice within the European Union
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DOI：
10.1016/j.physio.2012.12.011
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发表时间：
2013-12-01
期刊：
影响因子：
3.3
通讯作者：
Stokes, E. K.
中科院分区：
文献类型：
--
作者：
Bury, T. J.;Stokes, E. K.
背景直接访问是指服务用户能够在没有第三方推荐的情况下自行推荐物理治疗。它代表了一种得到全球专业支持的实践模式，越来越多的研究证据和一些卫生系统的卫生政策。据作者所知，还没有研究报告，以确定在何种程度上直接访问是可在物理治疗专业在欧洲联盟（EU）。目标调查的成员组织的世界联合会物理治疗（WCPT）;建立成员国的数量在欧盟内，它是可能的个人寻求物理治疗服务，自我介绍;描述提供物理治疗服务的立法/监管和报销背景;审查允许直接获取的会员国与不允许直接获取的会员国相比，物理治疗做法是否不同;并描述WCPT成员组织感知的直接访问的障碍和促进因素。设计横截面，在线调查使用有目的的样本。参与者WCPT在欧盟的成员组织。结果直接访问并不适用于欧盟的所有成员国，尽管大多数有立法来规范该行业，和初级教育方案，培养具备必要能力的毕业生。人们认为的主要障碍是那些可能影响政策制定的障碍，包括医学界和政治家的观点。服务用户和政治家的支持，以及专业自主权，被视为关键facilitator.Conclusion这些结果代表了第一份报告的全面映射的直接访问物理治疗和欧盟内的背景。在超过一半的成员国中，服务用户可以自我推荐物理治疗师。这些结果提供了见解，以进一步个人的理解的相似性和差异，在工作实践和服务提供的因素，如报销跨欧盟成员国和内部。障碍和促进者之间的协同作用表明，有针对性的宣传战略在引进直接访问/自我转诊到物理治疗的重要性。(C)2013年，物理治疗特许协会。由爱思唯尔有限公司出版。保留所有权利。
Background Direct access refers to service users being able to refer themselves to physiotherapy without a third-party referral. It represents a model of practice supported globally by the profession, growing research evidence and health policy in some health systems. To the authors' knowledge, no research has been reported to ascertain the extent to which direct access is available within the physiotherapy profession within the European Union (EU).Objectives To survey member organisations of the World Confederation for Physical Therapy (WCPT); establish the number of member states within the EU where it is possible for individuals seeking physiotherapy services to self-refer; describe the legislative/regulatory and reimbursement contexts in which physiotherapy services are delivered; examine if physiotherapy practice is different in member states where direct access is permitted compared with member states where direct access is not permitted; and to describe the barriers and facilitators to direct access perceived by member organisations of the WCPT.Design Cross-sectional, online survey using a purposive sample.Participants Member organisations of the WCPT in the EU.Results Direct access is not available in all member states of the EU, despite the majority having legislation to regulate the profession, and entry-level education programmes that produce graduates with the requisite competencies. Key barriers perceived are those that can influence policy development, including the views of the medical profession and politicians. Support of service users and politicians, as well as professional autonomy, are seen as key facilitators.Conclusion These results represent the first report of a comprehensive mapping of direct access to physiotherapy and contexts within the EU. In over half of member states, service users can self-refer to physiotherapists. These results provide insights to further individuals' understanding about the similarities and differences in working practices and service delivery factors, such as reimbursement across and within EU member states. The synergies between barriers and facilitators indicate the importance of targeted advocacy strategies in the introduction of direct access/self-referral to physiotherapy. (C) 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.