Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?Angela T. Chang A , Belinda Gavaghan B , Shaun O’Leary A C , Liza-Jane McBride B and Maree Raymer A D
A Department of Physiotherapy, Royal Brisbane and Women’s Hospital, Level 2, Ned Hanlon Building, Butterfield Street, Herston, Qld 4029, Australia. Email: firstname.lastname@example.org
B Allied Health Professions’ Office of Queensland, Clinical Excellence Division Department of Health, Queensland Government, Level 1, 15 Butterfield Street, Herston, Qld 4006, Australia. Emails: email@example.com; Liza-Jane.McBride@health.qld.gov.au
C School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Building (84A), Services Road, St Lucia, Qld 4072, Australia. Email: firstname.lastname@example.org
D Corresponding author. Email: email@example.com
Australian Health Review - https://doi.org/10.1071/AH16222
Submitted: 19 October 2016 Accepted: 25 March 2017 Published online: 15 May 2017
Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals.
Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated.
Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged.
Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services.
What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re-present for further specialist medical care.
What does this paper add? This paper identifies that the majority (95%) of patients managed by an advanced practice physiotherapy-led service did not re-present for further medical care for the same condition within 12 months of discharge.
What are the implications for practitioners? This paper supports the use of advanced practice physiotherapy-led services in the management of overburdened neurosurgical and orthopaedic specialist out-patient waiting lists.
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