COSTS OF PHYSIOTHERAPY SERVICES IN COLOMBIA. OSTEOMUSCULAR PHYSIOTHERAPY SERVICES PHASE

K.M. Alvis-Gómez^1,2,3, P. Vernaza-Pinzón^1,4, L.D. Jiménez-Rendón^1,5, C. Henao-Cardeño¹, E.J. Latorre-Quimbaya⁶, D.F. Guerrero-Yanza⁴, T. Ortiz-Vallejo⁴

¹Asociacion Colombiana de Fisioterapia (Colombian Physiotherapy Association), Bogotá, D.C., Colombia, ²Colegio Colombiano de Fisioterapeutas (Colombian Physiotherapists College), Bogotá, D.C., Colombia, ³Universidad Nacional de Colombia (National University of Colombia), Departamento del Movimiento Corporal Humano (Department of Human Body Movement), Bogotá, D.C., Colombia, ⁴Cauca University (Universidad del Cauca), Physiotherapy Department, Popayán, Colombia, ⁵Valle University (Universidad Del Valle), Human Rehabilitation School, Cali, Colombia, ⁶Universidad de la Sabana (La Sabana University), Department of Human Body Movement, Chía, Colombia

Background: Currently, Colombia does not have an updated cost study of the services provided in Physiotherapy in its various care modalities, which has led to the lack of parameters for the establishment and formulation of rates, as well as for the determination of cost-efficiency in the provision of services.

Purpose: Calculate the average costs for the activities carried out in the Physiotherapy services (First Time Consultation; Follow-up or Control Consultation; Comprehensive or General Physiotherapy; Physiotherapy Group Health Education; Physiotherapy Individual Health Education) in outpatient care, inpatient care, and home care modalities, in musculoskeletal physiotherapy services.

Methods: Multicenter, descriptive, cross-sectional study of an Activity-Based Costing (ABC) of physiotherapy services in Colombia for first-time consultation, follow-up, general care, and group and individual education will be carried out, in the musculoskeletal physiotherapy services, in the outpatient, inpatient, and home-care modalities, and in which the direct, indirect and intangible costs were characterized. The study counts on the participation of 60 physiotherapy services in 6 different Colombian geographical regions (Caribean, Center, Eastern Plains, West, East, and Southwest). The information on each service on the activities and relative costs was collected through a semi-structured interview (previously validated by 15 experts in physiotherapy management). This interview was carried out in remotely synchronous through the zoom and google meet platforms. Informed consent was obtained from the participants (service coordinators) and respect for the confidentiality of the information and adherence to the current habeas data regulations were guaranteed.

Results: The physiotherapy intervention activity presented an average of 40 minutes in the care process (range 20-75min). Educational activities are often carried out outside the session without counting the time of the activity, affecting the cost, despite the fact that an expense is generated. The cost of the consultation for the first time it is ranged between 2.6 -3.9 Current Legal Minimum Wages Day (CLMW) depending the modality of the service ( in-person hospital care or outpatient care) The domiciliariee attention presented a cost increased aproximately in 50-70% of the base-cost. The national average cost of a follow-up consultation is 2.5 CLMW in face-to-face consultation and 3.8 CLMW in home care. The average cost of a general or comprehensive care consultation is 4.4 CLMW in face-to-face consultation and 6.6 CLMW in home care. It must be taken into account that the care consultation includes costs related to the processes of: appointment assignment, billing, previous COVID records, biosafety actions, examination, evaluation, diagnosis, prognosis, closing of medical records. The study also reports the costs related to these activities.

Conclusions: The study allowed us to know the average session times in each of the processes and procedures paid for, as well as the human resource, the equipment, and accessories required to assure quality of services.

Implications: Knowing the cost of physiotherapy services allows determining times, human resources, equipment, supplies, and accessories for understanding the investment and the economic return of this investment, understanding at the same time, the complexities and differences between country regions.

Funding acknowledgements: ASOCIACION COLOMBIANA DE FISIOTERAPIA (Colombian Physiotherapy Association)- ASCOFI/ COLEGIO COLOMBIANO DE FISIOTERAPEUTAS (Colombian Physiotherapists College)-COLFI

Keywords:
Costing
Physiotherapy Services
Musculoskeletal

Topics:
Professional issues: business skills, leadership, advocacy & change management
Professional issues
Musculoskeletal

Did this work require ethics approval? Yes

Institution: Universidad Nacional de Colombia (National University of Colombia)

Committee: Ethics Committee Faculty of Medicine - National University of Colombia

Ethics number: CE-091-22