An overview of 5 years of patient self-referral for physical therapy in the Netherlands

Ilse C. S. Swinkels, Margit K. Kooijman, Peter M. Spreeuwenberg, D. Bossen, Chantal J. Leemrijse, Christel E. van Dijk, Robert Verheij, Dinny H. de Bakker, Cindy Veenhof

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Self-referral for physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing.
Objective
The aim of this study was to evaluate the effects of self-referral for physical therapy in the Netherlands, focusing on volume of general practice and physical therapy care (incidence rates and utilization of services).
Design
The study was based on monitoring data from existing data sources.
Methods
Longitudinal electronic medical record data from general practitioners (GPs) and physical therapists participating in the NIVEL Primary Care Database were used, as well as public data from Statistics Netherlands. Descriptive statistics and Poisson multilevel regression analyses were used for analyzing the data.
Results
Incidence rates of back (including low back), shoulder, and neck pain in general practice declined slightly from 2004 to 2009. No linear trends were found for number of contacts in GP care for back (including low back) and neck pain. The number of patients visiting physical therapists and the proportion of self-referrers are growing. Self-referrers receive treatment less often after initial intake than referred patients, and the mean number of visits is lower.
Limitations
This study was based on data of various patient populations from existing data sources.
Conclusions
The current study indicates that self-referral in the Netherlands has fulfilled most expectations held prior to its introduction, although no changes to the workload of GP care have been found. Use of physical therapy grew, but due to population aging and increasing prevalence of chronic diseases, it remains unclear whether self-referral affects health care utilization. Therefore, cost-benefit analyses are recommended.Subject: Health Policy & Administration, Cross-Cultural, Direct Access, Professional Issues
Original languageEnglish
Pages (from-to)1785-1795
JournalPhysical Therapy
Volume94
Issue number12
DOIs
Publication statusPublished - 2014

Cite this

Swinkels, I. C. S., Kooijman, M. K., Spreeuwenberg, P. M., Bossen, D., Leemrijse, C. J., van Dijk, C. E., ... Veenhof, C. (2014). An overview of 5 years of patient self-referral for physical therapy in the Netherlands. Physical Therapy, 94(12), 1785-1795. https://doi.org/10.2522/ptj.20130309
Swinkels, Ilse C. S. ; Kooijman, Margit K. ; Spreeuwenberg, Peter M. ; Bossen, D. ; Leemrijse, Chantal J. ; van Dijk, Christel E. ; Verheij, Robert ; de Bakker, Dinny H. ; Veenhof, Cindy. / An overview of 5 years of patient self-referral for physical therapy in the Netherlands. In: Physical Therapy. 2014 ; Vol. 94, No. 12. pp. 1785-1795.
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title = "An overview of 5 years of patient self-referral for physical therapy in the Netherlands",
abstract = "BackgroundSelf-referral for physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing.ObjectiveThe aim of this study was to evaluate the effects of self-referral for physical therapy in the Netherlands, focusing on volume of general practice and physical therapy care (incidence rates and utilization of services).DesignThe study was based on monitoring data from existing data sources.MethodsLongitudinal electronic medical record data from general practitioners (GPs) and physical therapists participating in the NIVEL Primary Care Database were used, as well as public data from Statistics Netherlands. Descriptive statistics and Poisson multilevel regression analyses were used for analyzing the data.ResultsIncidence rates of back (including low back), shoulder, and neck pain in general practice declined slightly from 2004 to 2009. No linear trends were found for number of contacts in GP care for back (including low back) and neck pain. The number of patients visiting physical therapists and the proportion of self-referrers are growing. Self-referrers receive treatment less often after initial intake than referred patients, and the mean number of visits is lower.LimitationsThis study was based on data of various patient populations from existing data sources.ConclusionsThe current study indicates that self-referral in the Netherlands has fulfilled most expectations held prior to its introduction, although no changes to the workload of GP care have been found. Use of physical therapy grew, but due to population aging and increasing prevalence of chronic diseases, it remains unclear whether self-referral affects health care utilization. Therefore, cost-benefit analyses are recommended.Subject: Health Policy & Administration, Cross-Cultural, Direct Access, Professional Issues",
author = "Swinkels, {Ilse C. S.} and Kooijman, {Margit K.} and Spreeuwenberg, {Peter M.} and D. Bossen and Leemrijse, {Chantal J.} and {van Dijk}, {Christel E.} and Robert Verheij and {de Bakker}, {Dinny H.} and Cindy Veenhof",
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language = "English",
volume = "94",
pages = "1785--1795",
journal = "Physical Therapy",
issn = "0031-9023",
publisher = "American Physical Therapy Association",
number = "12",

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Swinkels, ICS, Kooijman, MK, Spreeuwenberg, PM, Bossen, D, Leemrijse, CJ, van Dijk, CE, Verheij, R, de Bakker, DH & Veenhof, C 2014, 'An overview of 5 years of patient self-referral for physical therapy in the Netherlands', Physical Therapy, vol. 94, no. 12, pp. 1785-1795. https://doi.org/10.2522/ptj.20130309

An overview of 5 years of patient self-referral for physical therapy in the Netherlands. / Swinkels, Ilse C. S.; Kooijman, Margit K.; Spreeuwenberg, Peter M.; Bossen, D.; Leemrijse, Chantal J.; van Dijk, Christel E.; Verheij, Robert; de Bakker, Dinny H.; Veenhof, Cindy.

In: Physical Therapy, Vol. 94, No. 12, 2014, p. 1785-1795.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - An overview of 5 years of patient self-referral for physical therapy in the Netherlands

AU - Swinkels, Ilse C. S.

AU - Kooijman, Margit K.

AU - Spreeuwenberg, Peter M.

AU - Bossen, D.

AU - Leemrijse, Chantal J.

AU - van Dijk, Christel E.

AU - Verheij, Robert

AU - de Bakker, Dinny H.

AU - Veenhof, Cindy

PY - 2014

Y1 - 2014

N2 - BackgroundSelf-referral for physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing.ObjectiveThe aim of this study was to evaluate the effects of self-referral for physical therapy in the Netherlands, focusing on volume of general practice and physical therapy care (incidence rates and utilization of services).DesignThe study was based on monitoring data from existing data sources.MethodsLongitudinal electronic medical record data from general practitioners (GPs) and physical therapists participating in the NIVEL Primary Care Database were used, as well as public data from Statistics Netherlands. Descriptive statistics and Poisson multilevel regression analyses were used for analyzing the data.ResultsIncidence rates of back (including low back), shoulder, and neck pain in general practice declined slightly from 2004 to 2009. No linear trends were found for number of contacts in GP care for back (including low back) and neck pain. The number of patients visiting physical therapists and the proportion of self-referrers are growing. Self-referrers receive treatment less often after initial intake than referred patients, and the mean number of visits is lower.LimitationsThis study was based on data of various patient populations from existing data sources.ConclusionsThe current study indicates that self-referral in the Netherlands has fulfilled most expectations held prior to its introduction, although no changes to the workload of GP care have been found. Use of physical therapy grew, but due to population aging and increasing prevalence of chronic diseases, it remains unclear whether self-referral affects health care utilization. Therefore, cost-benefit analyses are recommended.Subject: Health Policy & Administration, Cross-Cultural, Direct Access, Professional Issues

AB - BackgroundSelf-referral for physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing.ObjectiveThe aim of this study was to evaluate the effects of self-referral for physical therapy in the Netherlands, focusing on volume of general practice and physical therapy care (incidence rates and utilization of services).DesignThe study was based on monitoring data from existing data sources.MethodsLongitudinal electronic medical record data from general practitioners (GPs) and physical therapists participating in the NIVEL Primary Care Database were used, as well as public data from Statistics Netherlands. Descriptive statistics and Poisson multilevel regression analyses were used for analyzing the data.ResultsIncidence rates of back (including low back), shoulder, and neck pain in general practice declined slightly from 2004 to 2009. No linear trends were found for number of contacts in GP care for back (including low back) and neck pain. The number of patients visiting physical therapists and the proportion of self-referrers are growing. Self-referrers receive treatment less often after initial intake than referred patients, and the mean number of visits is lower.LimitationsThis study was based on data of various patient populations from existing data sources.ConclusionsThe current study indicates that self-referral in the Netherlands has fulfilled most expectations held prior to its introduction, although no changes to the workload of GP care have been found. Use of physical therapy grew, but due to population aging and increasing prevalence of chronic diseases, it remains unclear whether self-referral affects health care utilization. Therefore, cost-benefit analyses are recommended.Subject: Health Policy & Administration, Cross-Cultural, Direct Access, Professional Issues

U2 - 10.2522/ptj.20130309

DO - 10.2522/ptj.20130309

M3 - Article

VL - 94

SP - 1785

EP - 1795

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

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Swinkels ICS, Kooijman MK, Spreeuwenberg PM, Bossen D, Leemrijse CJ, van Dijk CE et al. An overview of 5 years of patient self-referral for physical therapy in the Netherlands. Physical Therapy. 2014;94(12):1785-1795. https://doi.org/10.2522/ptj.20130309