Receipt of physical therapy among osteoarthritis patients and its influencing factors

Objective To explore major patient and provider characteristics influencing the receipt of physical therapy (PT) among patients newly diagnosed with osteoarthritis. Design A population-based, cross-sectional study on outpatient PT for patients newly diagnosed with osteoarthritis within the period of 2005 to 2010. Setting Sample of 1 million National Health Insurance enrollees. Participants People aged ≥18 years with an incidence of osteoarthritis and receiving initial outpatient treatment. A total of 29,012 patients were included (N=29,012). Interventions Not applicable. Main Outcome Measures The outcome variable of interest was the probability of receiving PT within 1 year of osteoarthritis diagnosis. Both individual and provider characteristics were investigated to determine their influence on PT receipt. Results Of the 29,012 included patients with osteoarthritis, only 24.8% of them received PT within the first year of diagnosis. Men and older adults were less likely to receive PT. In addition, low-income patients with osteoarthritis were less likely to receive PT. Furthermore, PT receipt was increased in patients treated by physicians who were women and by physicians who specialized in rehabilitation medicine. In addition, we observed a pattern indicating that the lower the accreditation level of the practice setting, the greater the probability of receiving PT. Conclusions Because of the National Health Insurance program in Taiwan, direct medical costs of PT have been substantially reduced; however, variations are still observed among different patient and provider characteristics. The major role of providers in PT receipt for patients with osteoarthritis should not be ignored.