To evaluate the effectiveness and cost effectiveness of specially trained physiotherapists in the assessment and management of defined referrals to hospital orthopaedic departments.
Setting-Orthopaedic outpatient departments in two hospitals.
Subjects-481 patients with musculoskeletal problems referred for specialist orthopaedic opinion.
Interventions-Initial assessment and management undertaken by post-Fellowship junior orthopaedic surgeons, or by specially trained physiotherapists working in an extended role (orthopaedic physiotherapy specialists).
Main outcome measures-Patient centred measures of pain, functional disability and perceived handicap.
A total of 654 patients were eligible to join the trial, 481 (73.6%) gave their consent to be randomised.
The two arms (doctor n=244, physiotherapist n=237) were similar at baseline.
Baseline and follow up questionnaires were completed by 383 patients (79.6%). The mean time to follow up was 5.6 months after randomisation, with similar distributions of intervals to follow up in both arms.
The only outcome for which there was a statistically or clinically important difference between arms was in a measure of patient satisfaction, which favoured the physiotherapist arm.
A cost minimisation analysis showed no significant differences in direct costs to the patient or NHS primary care costs.
Direct hospital costs were lower (p<0. (...)
Mots-clés Pascal : Système ostéoarticulaire pathologie, Muscle strié pathologie, Service hospitalier, Orthopédie, Physiothérapie, Médecin, Epidémiologie, Analyse coût efficacité, Evaluation, Traitement, Homme, Economie santé, Essai thérapeutique contrôlé, Personnel sanitaire
Mots-clés Pascal anglais : Diseases of the osteoarticular system, Striated muscle disease, Hospital ward, Orthopedics, Physiotherapy, Physician, Epidemiology, Cost efficiency analysis, Evaluation, Treatment, Human, Health economy, Controlled therapeutic trial, Health staff
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0483721
Code Inist : 002B30A04B. Création : 22/03/2000.