Background
-
What were the patient demographic and health related characteristics?
-
Which treatment processes were received?
-
What were the relationships between the patient demographic and health related characteristics and the number of visits per episodes in the three datasets examined?
Descriptions of the organization of physical therapy in the USA, Israel and the Netherlands
USA
Israel
The Netherlands
Methods
Clinical databases
Data set
Statistical analyses
Results
Patient demographic characteristics
Total population | FOTO | Maccabi | LiPZ | P | |
---|---|---|---|---|---|
Gender1
| % male | 37.2 | 39.6 | 42.0 | <0.001 |
% female | 62.8 | 60.4 | 58.0 | ||
Age2
| % 18–44 years | 33.8 | 35.0 | 40.7 | <0.001 |
% 45–64 years | 42.7 | 39.3 | 37.9 | ||
% 65–74 years | 13.7 | 15.0 | 11.1 | ||
% > 75 years | 9.7 | 10.7 | 10.3 | ||
mean age (sd) | 51.8 (16.2) | 52.0 (17.0) | 50.1 (17.2) | <0.001 | |
median age | 52 | 52 | 49 | ||
Number of patients | 62,798 | 99,541 | 12,193 | ||
Lumbar spine treated
| |||||
Gender3
| % male | 38.5 | 41.3 | 47.0 | <0.001 |
% female | 61.5 | 58.7 | 53.0 | ||
Age4
| % 18–44 years | 37.5 | 37.8 | 44.4 | <0.001 |
% 45–64 years | 39.2 | 38.3 | 38.9 | ||
% 65–74 years | 13.1 | 14.4 | 9.7 | ||
% > 75 years | 10.2 | 9.5 | 7.0 | ||
mean age (sd) | 51.0 (16.6) | 51.1 (16.6) | 48.7 (15.7) | <0.001 | |
median age | 50 | 51 | 47 | ||
Number of patients | 18,878 | 22,166 | 2,057 | ||
Treated for ankle sprain
| |||||
Gender | % male | 40.3 | 43.8 | 52.9 | 0.022 |
% female | 59.7 | 56.2 | 47.1 | ||
Age5
| % 18–44 years | 58.3 | 64.4 | 64.5 | <0.001 |
% 45–64 years | 36.1 | 27.5 | 24.5 | ||
% 65–74 years | 3.2 | 5.8 | 7.1 | ||
% > 75 years | 2.4 | 2.3 | 3.9 | ||
mean age (sd) | 41.5 (14.1) | 40.4 (15.3) | 40.6 (16.5) | 0.391 | |
Median age | 41 | 38 | 39 | ||
Number of patients | 472 | 1,463 | 155 |
Patient health characteristics
Total population1
| FOTO | Maccabi | LiPZ | P |
---|---|---|---|---|
Acute (0 – 21 days/1 month)2
| 18.4 | 14.3 | 38.0 | <0.001 |
Sub acute (21 days/1 month – 3 months)3
| 28.4 | 31.2 | 26.7 | |
Chronic (>3 months) | 53.2 | 54.5 | 35.2 | |
Number of patients (abs.) | 62,713 | 84,523 | 10,793 | |
Lumbar spine treated
4
| ||||
Acute (0 – 21 days/1 month) | 20.4 | 11.2 | 49.9 | <0.001 |
Sub acute (21 days/1 month – 3 months)3
| 24.4 | 25.5 | 23.9 | |
Chronic (>3 months) | 55.2 | 63.3 | 26.1 | |
Number of patients (abs.) | 18,873 | 19,809 | 1,950 | |
Treated for ankle sprain
5
| ||||
Acute (0 – 21 days/1 month) | 33.9 | 31.2 | 74.5 | <0.001 |
Sub acute (21 days/1 month – 3 months)3
| 41.3 | 41.6 | 16.1 | |
Chronic (>3 months) | 24.8 | 27.2 | 9.4 | |
Number of patients (abs.) | 472 | 1,361 | 149 |
FOTO1
| Maccabi2
| LiPZ3
| |
---|---|---|---|
Upper extremities | |||
Shoulder | 19.0 | 11.7 | 11.9 |
Arm (upper and/or forearm) | 0.9 | 2.0 | 2.2 |
Elbow | 1.4 | 3.0 | 2.8 |
Wrist/hand | 1.4 | 7.4 | 1.7 |
Total upper extremities
|
22.7
|
24.1
|
18.6
|
Lower extremities
| |||
Pelvis/hip | 5.8 | 4.7 | 5.4 |
Leg (upper and/or lower) | 3.1 | 1.5 | 4.9 |
Knee | 14.3 | 14.5 | 11.5 |
Ankle/foot | 7.4 | 7.8 | 3.0 |
Total lower extremities
|
30.6
|
28.5
|
24.8
|
Spinal impairments
| |||
Craniofacial | 0.2 | 0.2 | 1.5 |
Neck | 13.6 | 18.2 | 20.0 |
Ribs/trunk | 0.2 | 0.7 | 1.6 |
Thoracic spine | 2.0 | 4.2 | 11.7 |
Lumbar spine | 30.6 | 24.2 | 21.9 |
Total spinal impairments
|
46.6
|
47.5
|
56.7
|
Number of patients (abs.) | 61,672 | 91,565 | 9,413 |
Unknown (abs.) | 1,126 | 7,974 | 2,780 |
Treatment process
Total population | Maccabi | LiPZ | p |
---|---|---|---|
GP | 20.9 | 89.8 | <0.001 |
Orthopaedist | 67.4 | 3.8 | |
Neurologist | 1.5 | 0.6 | |
Rheumatologist | 0.4 | 0.2 | |
Other | 9.9 | 5.6 | |
Number of patients (abs.) | 99,541 | 12,193 | |
Lumbar spine treated
| |||
GP | 19.2 | 93.8 | <0.001 |
Orthopaedist | 73.3 | 0.4 | |
Neurologist | 0.6 | 0.6 | |
Rheumatologist | 0.2 | 0.0 | |
Other | 6.7 | 5.1 | |
Number of patients (abs.) | 22,166 | 2,057 | |
Treated for ankle sprain
| |||
GP | 8.7 | 95.5 | <0.001 |
Orthopaedist | 85.0 | 1.3 | |
Neurologist | 0.0 | 0.0 | |
Rheumatologist | 0.1 | 0.0 | |
Other | 6.2 | 3.2 | |
Number of patients (abs.) | 1,463 | 155 |
Total population | FOTO | Maccabi | LiPZ |
---|---|---|---|
Therapeutic exercise/advice | 78.0 | 79.4 | 84.5 |
Manual therapy | 31.8 | 54.7 | 67.2 |
Prescription, application and/or fabrication of devices | 2.2 | 2.9 | 1.6 |
Electrotherapeutic modalities | 22.5 | 41.7 | 4.5 |
Physical agents and mechanical modalities | 43.3 | 55.4 | 5.0 |
Other | 3.2 | 7.6 | 2.3 |
Number of patients – treatment closed (abs.) | 36,076 | 96,568 | 8,869 |
Lumbar spine treated
| |||
Therapeutic exercise/advice | 86.0 | 81.2 | 82.5 |
Manual therapy | 28.2 | 58.8 | 50.6 |
Prescription, application and/or fabrication of devices | 1.2 | 1.2 | 0.1 |
Electrotherapeutic modalities | 22.3 | 51.0 | 6.8 |
Physical agents and mechanical modalities | 42.1 | 56.1 | 2.4 |
Other | 4.6 | 5.0 | 1.4 |
Number of patients – treatment closed (abs.) | 6,756 | 15,493 | 1,895 |
Treated for ankle sprain
| |||
Therapeutic exercise/advice | 89.0 | 91.9 | 87.8 |
Manual therapy | 22.6 | 43.9 | 15.4 |
Prescription, application and/or fabrication of devices | 4.9 | 4.5 | 41.5 |
Electrotherapeutic modalities | 27.8 | 34.0 | 0.8 |
Physical agents and mechanical modalities | 56.0 | 58.8 | 1.6 |
Other | 6.1 | 2.6 | 2.4 |
Number of patients – treatment closed (abs.) | 327 | 1,411 | 123 |
FOTO | Maccabi | LiPZ | |||||||
---|---|---|---|---|---|---|---|---|---|
Total population
1
| b | SE | p | b | SE | p | b | SE | p |
Constant (male, 50 years, acute complaints) | 9.95 | 0.099 | 6.52 | 0.043 | 9.98 | 0.279 | |||
Female | -0.32 | 0.079 | <0.001 | 0.32 | 0.039 | <0.001 | 0.82 | 0.304 | 0.007 |
Age (in years) | 0.01 | 0.002 | <0.001 | 0.05 | 0.001 | <0.001 | 0.13 | 0.009 | <0.001 |
Sub acute complaints (reference = acute) | 0.33 | 0.113 | 0.003 | -0.01 | 0.052 | 0.953 | 1.78 | 0.378 | <0.001 |
Chronic complaints (reference = acute) | 0.60 | 0.103 | <0.001 | -0.80 | 0.046 | <0.001 | 4.84 | 0.349 | <0.001 |
Lumbar spine treated
2
| |||||||||
Constant (male, 50 years, acute complaints) | 8.09 | 0.143 | 5.44 | 0.102 | 8.85 | 0.409 | |||
Female | -0.11 | 0.120 | 0.345 | 0.57 | 0.066 | 0.062 | 0.75 | 0.487 | 0.126 |
Age (in years) | 0.003 | 0.002 | 0.173 | 0.04 | 0.002 | 0.158 | 0.05 | 0.015 | 0.003 |
Sub acute complaints | 0.81 | 0.172 | <0.001 | 0.06 | 0.115 | 0.005 | 1.57 | 0.607 | 0.010 |
Chronic complaints (reference = acute) | 1.248 | 0.149 | <0.001 | -0.25 | 0.104 | -0.026 | 2.25 | 0.583 | <0.001 |
Treated for ankle sprain
3
| |||||||||
Constant (male, 50 years, acute complaints) | 8.74 | 0.666 | 5.48 | 0.302 | 5.26 | 0.681 | |||
Female | -0.37 | 0.617 | 0.547 | 0.82 | 0.276 | 0.003 | 0.55 | 0.890 | 0.535 |
Age (in years) | 0.01 | 0.021 | 0.759 | 0.03 | 0.009 | 0.001 | 0.01 | 0.027 | 0.597 |
Sub acute complaints | 0.16 | 0.712 | 0.822 | -0.35 | 0.307 | 0.251 | 1.56 | 1.181 | 0.188 |
Chronic complaints | 2.59 | 0.783 | 0.001 | 0.64 | 0.340 | 0.058 | 3.09 | 1.394 | 0.028 |