Hogg-Johnson Sheilah, Cole Donald C, Lee Hyunmi, Beaton Dorcas E, Kennedy Carol, Subrata Peter
Senior Scientist, Institute for Work & Health, Dalla Lana School of Public Health, Toronto, ON.
Healthc Policy. 2011 Feb;6(3):e93-e108. doi: 10.12927/hcpol.2011.22180.
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.
在关于获得基本医疗服务的辩论中，门诊物理治疗服务的提供相对较少受到关注。我们调查了安大略省一个大型工会化工作场所中约2000名员工的肌肉骨骼疾病（MSD）物理治疗使用情况。我们从公共工作场所安全与保险委员会、两家私人医疗保险承保公司、一个始于1995年的工作场所特别基金以及一个始于1999年的工作场所签约的现场物理治疗诊所获得了与MSD相关的物理治疗理赔和服务数据。我们观察到MSD的总体物理治疗使用量大幅增加：1992 - 1994年每季度中位数为234次服务，到1999 - 2002年为1281次。随着包容性的工作场所提供政策，到1999 - 2002年，大多数物理治疗使用是在现场进行的（70%）。随着安大略省工作年龄成年人对门诊物理治疗服务的使用者付费倾向增加，在没有私人保险或没有直接服务提供的工作场所的人群中，存在获得服务不平等的巨大可能性。
