Jette A M, Smith K, Haley S M, Davis K D
New England Research Institute, Watertown, MA 02172.
Phys Ther. 1994 Feb;74(2):101-10; discussion 110-5. doi: 10.1093/ptj/74.2.101.
Although individuals with low back pain frequently receive treatment from a physical therapist, few published studies exist that describe who sees a physical therapist for their low back pain nor is much known about physical therapy episodes of care for this condition. Secondary analysis of data from the American Physical Therapy Association's Survey of Physical Therapy Outpatient Practice provides new descriptive data on services provided to a national, representative sample of patients discharged from hospital-based and private outpatient practices. In addition, specific hypotheses were tested on clinical and background factors believed to influence low back pain episodes of care.
Patients with low back pain represented over 25% of all outpatient discharges from physical therapy practices.
A mail survey was conducted with representatives of a national probability sample of facilities that provided outpatient physical therapy services. Data were provided on each facility and on a discharge sample of patients treated at each facility.
On average, episodes of care extended over 5 weeks and consisted of 11 therapy visits, for an average charge of $766.70. Duration and charge for low back episodes of care did not differ, on average, in private versus hospital-based practices. Certain aspects of care, however, did vary across regions of the country. Episodes of care charged to workers' compensation were costlier than those charged to other insurance carriers, and whites were charged less, on average, than nonwhites. Duration of back symptoms was related to intensity, duration, and charges incurred for the episode of care.
Further research is needed to understand the reasons for the relationships observed in this study, as well as studies that relate care provided by physical therapists to specific patient outcomes. Further research is also needed to compare outcomes achieved across different health professions.
尽管下背痛患者经常接受物理治疗师的治疗，但很少有已发表的研究描述哪些人因下背痛而寻求物理治疗师的帮助，对于这种疾病的物理治疗护理过程也知之甚少。对美国物理治疗协会门诊物理治疗实践调查数据的二次分析提供了有关向全国具有代表性的出院患者样本提供服务的新描述性数据，这些患者来自医院门诊和私人门诊。此外，还对被认为会影响下背痛护理过程的临床和背景因素进行了特定假设检验。
下背痛患者占物理治疗门诊所有出院患者的25%以上。
对提供门诊物理治疗服务的全国概率抽样设施的代表进行了邮件调查。提供了每个设施的数据以及在每个设施接受治疗的出院患者样本的数据。
护理过程平均持续5周，包括11次治疗就诊，平均费用为766.70美元。在私立与医院门诊中，下背痛护理过程的持续时间和费用平均没有差异。然而，护理的某些方面在全国不同地区确实有所不同。工伤赔偿的护理费用比其他保险公司支付的费用更高，而且白人平均收费低于非白人。背部症状的持续时间与护理过程的强度、持续时间和费用有关。
需要进一步研究以了解本研究中观察到的关系的原因，以及将物理治疗师提供的护理与特定患者结局相关联的研究。还需要进一步研究以比较不同健康专业所取得的结局。
