Piano Leonardo, Maselli Filippo, Viceconti Antonello, Gianola Silvia, Ciuro Aldo
Unit of Rehabilitation and Functional Recovery, Casa di Cura La Residenza, Italy.
Sovrintendenza Sanitaria Regionale Puglia INAIL, Italy.
J Phys Ther Sci. 2017 Aug;29(8):1463-1471. doi: 10.1589/jpts.29.1463. Epub 2017 Aug 10.
[Purpose] To present legislation comparing direct and referred access-or other measures-to physical therapy. The focus is on the management of the most burdensome musculoskeletal disorders in terms of regulations, costs, effectiveness, safety and cost-effectiveness. [Methods] Main biomedical databases and gray literature were searched ranging from a global scenario to the analysis of targeted geographical areas and specifically Italy and the Region Piedmont. [Results] legislation on Direct Access highlights inconsistencies among the countries belonging to World Confederation for Physical Therapy. Direct Access could be an effective, safe and efficient organization model for the management of patients with musculoskeletal diseases and seems to be more effective safer and cost effective. [Conclusion] Direct Access is a virtuous model which can help improve the global quality of physical therapy services. Further studies are required to confirm this approach and determine whether the findings of the present overview can be replicated in different countries and healthcare systems.
[目的] 介绍比较直接就诊和转诊至物理治疗或其他措施的相关立法。重点在于从法规、成本、有效性、安全性和成本效益方面对最繁重的肌肉骨骼疾病进行管理。[方法] 检索了主要生物医学数据库和灰色文献，范围从全球情况到对目标地理区域（特别是意大利和皮埃蒙特地区）的分析。[结果] 直接就诊立法凸显了世界物理治疗联合会所属国家之间的不一致性。直接就诊对于肌肉骨骼疾病患者的管理可能是一种有效、安全且高效的组织模式，并且似乎更有效、更安全且具有成本效益。[结论] 直接就诊是一种有助于提高全球物理治疗服务质量的良性模式。需要进一步研究来证实这种方法，并确定本综述的结果是否能在不同国家和医疗保健系统中得到复制。
