+ Co- payme nts injur ing physiothe r apy? A c a se study o f a - - PowerPoint PPT Presentation

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Co- payme nts injur ing physiothe r apy?

A c a se study o f a priva te pra c tic e in Auc kla nd, Ne w Ze a la nd in 2013.

+ Ba c kg ro und

 Be fo re 2009, no c ha rg e fo r ACC pa tie nts  F

ro m 2009 o nwa rds, pa tie nts c ha rg e d a c o -pa yme nt

 Co nc e rn ra ise d b y sta ke ho lde rs  Dr Nic k Smith: “ACC will mo nito r c lie nt

a c c e ss to se e if the re is a n a dve rse impa c t

• n a ny spe c ific g ro up” (ACC, 2009a , p1)

 No e vide nc e o f this.

+ Study q ue stio n

 Wha t a re the c o nse q ue nc e s o f the physio the ra py pa tie nt

c o -pa yme nts fo r a priva te pra c tic e in Auc kla nd, Ne w Ze a la nd?

 Re sults to re fle c t c o nfide nc e in o r c o nc e rn a b o ut the

c ha ng e in po lic y

 Re sults ma y indic a te whe the r a

la rg e -sc a le Go ve rnme nt e nq uiry is ne c e ssa ry, a s wa s o rig ina lly pro mise d

+ Study’ s ne c e ssity

 L

ite ra ture re vie w o f 11 studie s inve stig a te d the e ffe c ts o f c o -pa yme nts o n pa tie nts se e king prima ry he a lth c a re

 Re sults sho we d tha t e xisting c o -pa yme nts:

 De c re a se utilisa tio n  De c re a se he a lth sta tus  Ne g a tive ly impa c t life style

 Mixe d re sults fo r inc re asing

• r intro duc ing a c o -pa yme nt

 ACC’ s c o -pa yme nt ha s no w

b e e n e xisting fo r fo ur ye a rs

+ Study de sig n

 Qua lita tive study de sig n  Ca se study o f a priva te pra c tic e  Purpo sive sa mpling  E

ig ht pa rtic ipa nts via ‘ typic a l c a se sa mpling ’

 F

• ur pa tie nts via ‘ ma ximum va ria tio n sa mpling ’

+ Pa rtic ipa nt re c ruitme nt

 Priva te pra c tic e in Gle n I

nne s via Physio the ra py So c ie ty

 Pa rtic ipa nt I

nfo rma tio n She e t issue d to sta ff a nd pa tie nts

 Pa rtic ipa nt e lig ib ility c rite ria :  Wo rke d/ a tte nde d c linic fro m b e fo re -2009 to c urre nt

da te

 Ab le to c o mmunic a te in E

ng lish

 T

ho se inte re ste d e ma ile d myse lf o r my supe rviso r

+ Da ta c o lle c tio n & a na lysis

 Se mi-struc ture d inte rvie ws with pre -de te rmine d q ue stio ns  I

n-pe rso n inte rvie ws

 Priva te ro o ms a t physio the ra py c linic  I

nduc tive a na lysis (T ho ma s, 2006)

+ Re sults (so fa r)

 F

ra nc hise ma na g e r, c linic a l ma na g e r, physio the ra pist a nd re c e ptio nist:

 De c re a se utilisa tio n o f physio the ra py, e spe c ia lly lo w SE

S

 De c re a se d fre q ue nc y o f a ppo intme nts pe r pa tie nt  Pa tie nts pre se nting with mo re c hro nic injurie s  Physio the ra pists lo sing pa yme nts  De c re a se d time spe nt with pa tie nts = de c re a se d q ua lity?  I

nc re a se d pa tie nt c o mplia nc e

 T

wo pa tie nts to inte rvie w this we e k

+ Stre ng ths a nd limita tio ns

 Stre ng ths

 Qua lita tive no t q ua ntita tive  Se mi-struc ture d a nd in-pe rso n inte rvie ws  Que stio ns use d

 L

imita tio ns

 Ca se study is no t g e ne ra lisa b le  Sma ll numb e r o f pa rtic ipa nts  Physio the ra pists o ve r-re pre se nte d  Ulte rio r mo tive fo r pa rtic ipa tio n?  Po sitio na lity

+ Sig nific a nc e a nd implic a tio ns

• f finding s

 F

inding s a re simila r to tho se o f lite ra ture re vie w

 Do e s no t imply tha t the se re sults will b e fo und in e ve ry

priva te physio the ra py pra c tic e

 But it do e s indic a te tha t the re is a ne e d to re se a rc h the se

e ffe c ts furthe r, a s the c urre nt re sults sho w the c o -pa yme nts a re ne g a tive ly e ffe c ting pa tie nts a nd physio the ra pists

 F

uture re se a rc h sho uld inc lude :

 Gre a te r numb e rs o f pa rtic ipa nts  Pa rtic ipa nts who c a n no lo ng e r se e k physio the ra py  Pa rtic ipa nts o f diffe ring SE

S