The aim of the data collection was to gather evidence regarding the state of physiotherapy in PHC in Europe.
A structured online survey was sent to representatives of the Europe Region World Physiotherapy member organisations and of the seven countries not involved in the Region, by the Advocacy and European Matters Working Group. The survey collected specific information regarding the legal inclusion of physiotherapy in PHC, the number of physiotherapists working in PHC, the activities performed, their level of autonomy and the satisfaction with the level of autonomy of physiotherapists in PHC.
Of the 45 countries that received the survey, 37 participated and submitted their answers. Twenty-seven organisations stated that physiotherapy was integrated in the public healthcare system and 25 have reported being integrated in PHC in the private healthcare system. In 6 countries physiotherapy is not included in public or private healthcare systems. Only 21 countries provided an estimated number of physiotherapists working in PHC in the public system, and only in 5 countries the data was provided from an official source. The reported median number of physiotherapists working in PHC was 34.9% of the physiotherapists mentioned in the country profile of the Europe Region in the public system and 43.1% of the physiotherapists mentioned in the country profile in the private system. A medical referral is necessary to access physiotherapy services in PHC in 25 countries. In 14 countries the physiotherapist is legally authorised to assess and diagnose the patient, however in 6 countries both the assessment and diagnosis are not allowed. In the remaining countries, assessment is authorised, but diagnosis is not allowed, or unknown if allowed. Physiotherapists are legally authorised to define the treatment plan in 29 countries. The ability to legally refer patients to general practitioners, medical specialists, other healthcare professionals, and imaging modalities and other diagnostic tests is very limited. The activities performed by physiotherapists are centred in individual treatment, educational activities towards patients and caregivers, prevention and management of chronic conditions and promoting health and wellness in the community. Overall, the mean level of satisfaction with their level of autonomy was 4.6 on a 10-point scale.
The responses provide a good picture of the state of physiotherapy in PHC in Europe. The elements contributing to or prohibiting acting autonomously are charted. Follow-up studies can highlight trends and changes. Considering the different levels of satisfaction across the countries, specific advocacy strategies are necessary.
The Europe Region of World Physiotherapy can use the results to assist member organisations through specific advocacy actions when targeting identified aspects from the survey. In addition, the information can be used by researchers as benchmark data and policymakers can benefit to further the physiotherapy profession.
Professional autonomy
Europe
