Department of Physical Therapy, University of Illinois at Chicago College of Applied Health Sciences, Chicago, IL 60612 (USA).
Department of Physical Therapy, University of Illinois at Chicago College of Applied Health Sciences.
Phys Ther. 2019 Aug 1;99(8):1020-1026. doi: 10.1093/ptj/pzz015.
Significant progress has been made in implementing direct access. As more therapists transition into direct access roles, it seems prudent to consider how additional resources common to other first-contact providers might impact patient care.
Direct referral for diagnostic imaging by physical therapists is relatively rare in the civilian setting and little has been published on the subject. The primary objective of this study was to examine the appropriateness of diagnostic imaging studies referred by civilian physical therapists at an academic medical center. Secondary objectives were to track reimbursement data and overall use rates.
This was a single-center, retrospective practice analysis of 10 physical therapists over a period of nearly 5 years.
The electronic medical record was reviewed for each patient who had an imaging referral placed by a physical therapist. Relevant clinical exam findings and patient history were provided to a radiologist who then applied the American College of Radiology Appropriateness Criteria to determine appropriateness. Reimbursement data and therapist use rates were also evaluated.
Of the 108 total imaging studies, 91% were considered appropriate. Overall, use rates per direct access evaluation were 9% for plain film x-rays and 4% for advanced imaging. Reimbursement was 100%.
This study was limited to 10 physical therapists at 1 practice location. Appropriateness was evaluated by 1 radiologist. The educational background of referring therapists was not evaluated.
Physical therapists demonstrated appropriate use of diagnostic imaging in the vast majority of cases (91%). They were judicious in their use of imaging, and there were no issues with reimbursement. These findings could be useful for physical therapists interested in acquiring diagnostic imaging referral privileges.
直接访问已经取得了重大进展。随着越来越多的治疗师过渡到直接访问角色，考虑其他第一接触提供者常见的额外资源如何影响患者护理似乎是明智的。
在民用环境中，物理治疗师直接转介进行诊断性影像学检查相对较少，对此主题的研究也很少。本研究的主要目的是检查学术医疗中心的民用物理治疗师转介的诊断性影像学研究的适宜性。次要目标是跟踪报销数据和总体使用率。
这是一项对近 5 年来 10 名物理治疗师的单中心回顾性实践分析。
对每位由物理治疗师进行影像学转诊的患者的电子病历进行了审查。向放射科医生提供了相关的临床检查结果和患者病史，然后放射科医生应用美国放射学院适宜性标准来确定适宜性。还评估了报销数据和治疗师使用率。
在总共 108 项影像学研究中，91%被认为是适宜的。总体而言，直接访问评估的使用率为平片 x 光 9%，高级影像学 4%。报销率为 100%。
本研究仅限于 1 个实践地点的 10 名物理治疗师。适宜性由 1 名放射科医生进行评估。未评估转诊治疗师的教育背景。
在绝大多数情况下（91%），物理治疗师对诊断性影像学的使用是适宜的。他们在使用影像学方面很谨慎，并且不存在报销问题。这些发现对于有兴趣获得诊断性影像学转诊权限的物理治疗师可能有用。
