IDENTIFYING FACTORS PREVENT PATIENTS ACCESSIBILITY TO MUSCULOSKELETAL PHYSICAL THERAPY IN SAUDI ARABIA: A RETROSPECTIVE COHORT ANALYSIS

T. Alshammari¹, A. Alonazi¹, A. Alsweed¹, R. Alasous¹, S. Alshammari²

¹Prince Sultan Military Medical City, Physical Therapy, Al Riyadh, Saudi Arabia, ²Ministry of National Guard King Abdulaziz Medical City, Physical Therapy, Al Riyadh, Saudi Arabia

Background: Musculoskeletal disorders are common and linked to an increased risk of developing disability. Although physical therapy is recommended for several musculoskeletal disorders, research shows the rate of patients' access to clinics for physical therapy appears unchanged.

Purpose: Here we aimed to examine the impact of variables on patients' access to physical therapy.

Methods: Our study is designed as a retrospective cohort and conducted in Prince Sultan Military Medical City (PSMMC) using electronic medical records (EMR). We included the EMR of patients examined between March 30th and May 22nd, 2022. The sample was divided into two main groups, users and non-users of physical therapy services after referral. Multiple variables were included, such as gender, age, diagnoses, co-existence of other medical conditions, patients' height, weight, and body mass index. Data were analyzed using students' t-test, Pearson's χ2 independence test, and multiple regression. This project is ethically approved by the PSMMC local IRB ethics committee (IRB#1636).

Results: Of 740 participants, 70.4% were females, and 26.6% were males. Age ranged from 15 to 83, with a mean height of 160.29±9.452 and weight of 79.63±15.922. Where the mean BMI was 31.21±6.677. Our results indicated that 57.3% are non-user. About 77.3% of participants attend outpatient department. 57.7% of cases presented by lower extremity diagnosis, and about 45% had comorbidities. The person chi-square analysis indicated that gender and clinic factors are significantly associated with physical therapy referral. At the same time, the regression analysis suggested that with every increase in one unit in gender, physical therapy will significantly decrease by 0.200. Females tend to be more accessible to musculoskeletal physical therapy than males. Additionally, we found a trend in the association between the clinic and the physical therapy referral, indicating that changing the clinic contributes to the accessibility to the physical therapy sessions.

Conclusions: Our study highlights a substantial number of physical therapy referrals are non-users. Most of them are males. Indicating the unmet need to address these gaps. We suggest to:1) include full explanations of the benefit of completing the physical therapy sessions in the referral form, mainly for male patients. 2) include a physical therapist in physician clinics. This move would reduce the number of referral non-user by addressing all patients' questions and needs about changing clinics. Additionally, this would strategize the referral by targeting the destination clinic and filtering the referral numbers.

Implications: The study goals would fill our knowledge gap in understanding factors contributing to dropping physical therapy referrals. Additionally, it might aid in translating our work and guide healthcare professionals and policymaking individuals to highlight individuals at particular risk of not accessing physical therapy.

Funding acknowledgements: Not funded

Keywords:
Musculoskeletal
Physical Therapy
Dropping referrals

Topics:
Globalisation: health systems, policies & strategies
Musculoskeletal

Did this work require ethics approval? Yes

Institution: Prince Sultan Military Medical City

Committee: IRB

Ethics number: 1636