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加拿大魁北克省公共资助的门诊肌肉骨骼物理治疗服务的需求与供给差异。

Variations in demand and provision for publicly funded outpatient musculoskeletal physiotherapy services across Quebec, Canada.

作者信息

Deslauriers Simon, Raymond Marie-Hélène, Laliberté Maude, Lavoie Amélie, Desmeules François, Feldman Debbie E, Perreault Kadija

机构信息

Faculty of Medicine, Université Laval; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Canada.

School of Rehabilitation, Faculty of Medicine, Université de Montréal; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada.

出版信息

J Eval Clin Pract. 2017 Dec;23(6):1489-1497. doi: 10.1111/jep.12838. Epub 2017 Oct 23.

Abstract

RATIONALE

The prevalence of musculoskeletal disorders is high and expected to increase in the next decade. Persons suffering from musculoskeletal disorders benefit from early physiotherapy services. However, access to publicly funded physiotherapy services has been shown to be compromised by long waiting times and limited availability of resources in many countries around the world. Decisions on resource allocation may create geographic disparities in provision and access to services, which may result in inequity in access.

AIMS AND OBJECTIVES

This study aimed to assess variations in demand and provision of publicly funded outpatient physiotherapy services across the province of Quebec, Canada, as well as to assess the demand to provision relationship.

METHODS

We conducted a secondary analysis of data retrieved from the 2008 Quebec Health Survey and data obtained from a survey of hospitals in the province of Quebec in 2015. We used geographic information systems analyses and descriptive analyses to assess geographic variations and the relationship between demand and provision.

RESULTS

Our results indicate substantial variations in the provision and demand for physiotherapy services in the province of Quebec. The variations in service provision did not follow the variations in demand. Long waiting times and insufficient provision of services were found in many regions.

CONCLUSIONS

The variations in provision of physiotherapy services between regions reported in our study did not correspond to the variations in demand. Such geographic variations and demand to provision mismatches may create inequity in access to services, especially for those unable to afford private services.

摘要

理论依据

肌肉骨骼疾病的患病率很高,预计在未来十年还会上升。患有肌肉骨骼疾病的人能从早期物理治疗服务中受益。然而,在世界上许多国家,获得公共资助的物理治疗服务受到长时间等待和资源有限的影响。资源分配决策可能会在服务提供和获取方面造成地域差异,这可能导致获取服务的不平等。

目的

本研究旨在评估加拿大魁北克省公共资助的门诊物理治疗服务的需求和提供情况的差异,以及评估需求与提供之间的关系。

方法

我们对从2008年魁北克健康调查中检索到的数据以及从2015年魁北克省医院调查中获得的数据进行了二次分析。我们使用地理信息系统分析和描述性分析来评估地理差异以及需求与提供之间的关系。

结果

我们的结果表明,魁北克省物理治疗服务的提供和需求存在很大差异。服务提供的差异与需求的差异不一致。在许多地区发现等待时间长且服务提供不足。

结论

我们研究中报告的各地区物理治疗服务提供的差异与需求的差异不相符。这种地理差异和需求与提供的不匹配可能会造成获取服务的不平等,尤其是对于那些无力支付私人服务费用的人。

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