Hendriks Erik J M, Kerssens Jan J, Nelson Roger M, Oostendorp Rob A B, van der Zee Jouke
Department of Research and Development, Dutch National Institute of Allied Health Professions (NPi), PO Box 1161, 3800 BD Amersfoort, The Netherlands.
Phys Ther. 2003 Oct;83(10):918-31.
One-time physical therapist consultation, prior to possible referral for physical therapy intervention, may enhance the quality of patient care, particularly if the referring physician is uncertain as to whether intervention by a physical therapist will be beneficial. The purpose of this study was to describe the use of consultation by a group of primary care physicians (PCPs) who could refer patients for a one-time consultation.
A 7-month observational study was conducted in the Netherlands with 59 pairs of randomly selected PCPs and physical therapists practicing in primary health care. Data were collected for the PCPs, the physical therapists, and the patients. Self-administered questionnaires (completed at the start and at the completion of the study), consultation request and report forms, and treatment referral records from health insurance agencies were used to obtain data. National reference data on patients referred by PCPs for intervention by a physical therapist were used to compare the data of patients referred by PCPs for a one-time consultation. The number and nature of consultation requests were determined as well as patient characteristics. The PCPs' satisfaction with the outcome and process of a one-time consultation and its impact on PCPs' management decisions also were described.
The number of referrals for a one-time consultation was 352 (X=5.9 per PCP, SD=5.4, range=0-20), resulting in a mean referral rate of 4.7 per 1,000 patients (SD=4.6). Characteristics of patients referred for a one-time consultation differed from national reference data of patients referred by their PCP for intervention by a physical therapist.
The results show that PCPs used the opportunity for a one-time physical therapist consultation and were satisfied with the outcome and process of consultation. The findings suggest that a one-time consultation is an appropriate and beneficial component of PCPs' patient management process.
在可能转介患者接受物理治疗干预之前，由物理治疗师进行一次性会诊，可能会提高患者护理质量，尤其是当转诊医生不确定物理治疗师的干预是否会有益时。本研究的目的是描述一组可转介患者进行一次性会诊的初级保健医生（PCP）对会诊的使用情况。
在荷兰进行了一项为期7个月的观察性研究，有59对随机选择的在初级卫生保健机构执业的初级保健医生和物理治疗师参与。收集了初级保健医生、物理治疗师和患者的数据。使用自我填写的问卷（在研究开始和结束时完成）、会诊请求和报告表以及医疗保险机构的治疗转诊记录来获取数据。使用初级保健医生转介患者接受物理治疗师干预的国家参考数据，来比较初级保健医生转介患者进行一次性会诊的数据。确定了会诊请求的数量和性质以及患者特征。还描述了初级保健医生对一次性会诊结果和过程的满意度及其对初级保健医生管理决策的影响。
一次性会诊的转诊数量为352例（平均每位初级保健医生转诊5.9例，标准差=5.4，范围=0 - 20），平均转诊率为每1000名患者4.7例（标准差=4.6）。被转介进行一次性会诊的患者特征与初级保健医生转介患者接受物理治疗师干预的国家参考数据不同。
结果表明，初级保健医生利用了由物理治疗师进行一次性会诊的机会，并且对会诊结果和过程感到满意。研究结果表明，一次性会诊是初级保健医生患者管理过程中适当且有益的组成部分。
