Changes in physiotherapy utilization in one workforce: implications for accessibility among Canadian working-age adults.
Hogg-Johnson-S; Cole-DC; Lee-H; Beaton-DE; Kennedy-C; Subrata-P; The Workplace Upper Extremity Research Group
Healthc Policy 2011 Feb; 6(3):e93-e108
In debates over access to essential medical care, comparatively little attention has been paid to the provision of outpatient physiotherapy services. We examined physiotherapy utilization for musculoskeletal disorders (MSDs) among approximately 2,000 employees of a large, unionized, Ontario workplace. We obtained MSD-related physiotherapy claims and service data from the public Workplace Safety and Insurance Board, two private medical insurance carriers, a workplace special fund starting in 1995 and a workplace-contracted, on-site physiotherapy clinic starting in 1999. We observed substantial increases in overall physiotherapy utilization for MSDs: a median of 234 services per quarter for 1992-1994 to 1,281 for 1999-2002. With inclusive workplace provision policies, most physiotherapy utilization occurred on-site by 1999-2002 (70%). With a user-pay orientation to outpatient physiotherapy services increasing among working-age adults in Ontario, there is substantial potential for unequal access among those not privately insured or in workplaces with direct service provision.
Employee-health; Physical-therapy; Outpatient-facilities; Health-care; Health-programs; Health-services; Musculoskeletal-system-disorders; Physiological-effects; Medical-services; Medical-treatment
Sheilah Hogg-Johnson, Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9
The Institute for Work and Health, Toronto, Ontario, Canada