Crout K L, Tweedie J H, Miller D J
HealthAlliance-Fairlawn Nursing Center, Leominster, MA 01453, USA.
Phys Ther. 1998 Jan;78(1):52-61. doi: 10.1093/ptj/78.1.52.
This study examined whether differences exist about physical therapists' opinions and practices regarding the use of direct access between therapists practicing in Massachusetts, a direct-access state, and therapists practicing in Connecticut, a state that allows only evaluation without referral. A second purpose was to examine direct-access practices of therapists in Massachusetts.
A sample of 329 therapists in Massachusetts and 179 therapists in Connecticut were surveyed.
A cover letter, questionnaire, and return-reply envelope were mailed to each therapist. Independent group t tests and chi-square analyses were used to determine whether therapists' opinions about direct access differed between states. Frequencies were calculated to examine direct-access practices of therapists in Massachusetts.
Adjusted response rates were 65.5% in Massachusetts and 57.9% in Connecticut. Therapists in both states were equally supportive of direct access (74.9%). Therapists in Connecticut were more supportive of three stipulations regulating direct access than therapists in Massachusetts were. In Massachusetts, 34.0% of the respondents stated that they practiced using direct access, and 8.8% of the patients seen by the therapists sampled were treated without physicians' referrals. The therapists indicated that the most common reasons for limited use of direct access were employer policies and lack of insurance reimbursement.
Therapists in Connecticut favored more stipulation regulating direct access than therapists in Massachusetts did. Although therapists in both states appear to be supportive of direct access, the number of patients in Massachusetts seen through this mode of care appears to be limited because of practice and financial restraints.
本研究调查了在允许直接就诊的马萨诸塞州执业的物理治疗师与仅允许在无转诊情况下进行评估的康涅狄格州执业的物理治疗师，在直接就诊的看法和实践方面是否存在差异。第二个目的是研究马萨诸塞州治疗师的直接就诊实践情况。
对马萨诸塞州的329名治疗师和康涅狄格州的179名治疗师进行了抽样调查。
向每位治疗师邮寄了一封附信、一份问卷和一个回邮信封。采用独立样本t检验和卡方分析来确定不同州的治疗师对直接就诊的看法是否存在差异。计算频率以研究马萨诸塞州治疗师的直接就诊实践情况。
马萨诸塞州的调整回复率为65.5%，康涅狄格州为57.9%。两个州的治疗师对直接就诊的支持程度相同（74.9%）。与马萨诸塞州的治疗师相比，康涅狄格州的治疗师更支持对直接就诊的三项规定。在马萨诸塞州，34.0%的受访者表示他们采用直接就诊的方式进行治疗，且抽样治疗师所诊治的患者中有8.8%是在没有医生转诊的情况下接受治疗的。治疗师指出，直接就诊使用受限的最常见原因是雇主政策和缺乏保险报销。
与马萨诸塞州的治疗师相比，康涅狄格州的治疗师更倾向于对直接就诊进行更多规定。尽管两个州的治疗师似乎都支持直接就诊，但由于实践和经济限制，通过这种护理模式在马萨诸塞州就诊的患者数量似乎有限。
