PTs more Cost-effective than MDs in an Outpatient Orthopaedic Dept.

This British RCT evaluated the clinical effectiveness and cost effectiveness of orthopaedic trained Physiotherapists in the assessment and management of referrals to two hospital orthopaedic departments.

Patients with musculoskeletal problems referred for specialist orthopaedic opinion were randomly allocated to receive their initial assessment and management either by post-fellowship junior orthopaedic Physicians (n=244) or by orthopaedic trained Physiotherapists (N=237).

Result #1: Compared to the Orthopaedic Physician, overall patient satisfaction was statistically significantly higher for the patients receiving evaluation and management by a Physiotherapist.

Result #2: Direct hospital costs were significantly lower (p < 0.00001) for the patients seen by Physiotherapists (almost half the cost)!!!

Average cost per patient
PT = 256 Pounds (Approx. $500)
MD = 498 pounds (Approx. $1000)

Patient satisfaction Scores
PT > MD

Result #3: Physiotherapists were less likely to order radiographs than MDs.

Result #4: Physiotherapists were less likely to refer patients for orthopaedic surgery than MDs.

Conclusion: This RCT demonstrated that orthopaedic physiotherapy specialists are as effective as Physicians and clinical assistant orthopaedic surgeons in the initial assessment and management of new referrals to outpatient orthopaedic departments, furthermore Physiotherapists generate lower initial direct hospital costs.

Posted on: January 21, 2011

Categories: Relevant Physical Therapy Articles

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