Het gebruik van kinesitherapie en van fysische geneeskunde ... - KCE

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66 Physiotherapy & Physical and Rehabilitation Medicine KCE Reports 87 Table 24 : Proportion of outpatient PT sessions in hospital (ambulatory) Percentage of outpatient PT sessions performed in hospital Arthrodesis of dorso-lumbar spine 0.66% Knee arthroplasty 1.51% Fractured ankle 1.29% Fractured forearm 2.64% Fractured femur 0.39% Fractured tibia 0.91% Knee ligament or subluxation 2.54% Hallux valgus 1.01% Herniated disk 1.31% Urinary incontinence 2.24% Cervical spine operation 2.70% One day carpal tunnel release 4.91% Mastectomy 3.53% One day meniscectomy 2.88% Inpatient meniscectomy 2.20% Hip Prosthesis 6.17% Shoulder & upper arm, major 0.66% Shoulder, minor operation 1.28% Total 2.13% 4.2.3 Differences between populations according to the type of rehabilitation 4.2.3.1 Length of stay in hospital Few differences were observed in the distribution of the length of stay in hospital for the different types of rehabilitation. The length of stay was longer when the rehabilitation consisted of multi-disciplinary PRM, but these differences were generally limited to rehabilitation occurring during hospitalisation. The longest lengths of stay were observed for mixed "PT & multi-disciplinary PRM" rehabilitations following hip prosthesis. Similarly, lengths of stay were longer for rehabilitation by exclusive or mixed multidisciplinary PRM, following shoulder procedures, shoulder and upper arm procedures and knee arthroplasty. Details in Appendix 17. 4.2.3.2 Patient characteristics Regardless of whether the patients received their rehabilitation on an outpatient basis (possibly with a care sequence during hospitalisation), or only during hospitalisation, there were few differences between the patient profiles based on the type of rehabilitation. These differences, although small, were statistically significant for most of the characteristics.
KCE Reports 87 Physiotherapy & Physical and Rehabilitation Medicine 67 Patients receiving rehabilitation only during hospitalisation For these patients, the association with the type of rehabilitation (see Appendix 17) was most marked, with: • Stay in a specialist rehabilitation service; • Unemployment rate in the statistical quarter (which is a proxy of the socioeconomic status in that quarter); • Income level of the household; • “Minor risk” entitlement coverage: non-entitled patients received more multidisciplinary PRM. Patients receiving outpatient rehabilitation (either exclusively or in combination with rehabilitation during hospitalisation) The highest degree of association with the type of rehabilitation (see Appendix 17) was observed with: • Existence and type of rehabilitation during 30 days before surgery: patients who had PRM rehabilitation after surgery had more often received PRM rehabilitation before the intervention (except for the mono PRM rehabilitation); • The household income level; • “MAF” activated for the patient: patients receiving multi-disciplinary PRM rehabilitation were often in this situation. This occurred less frequently if the rehabilitation consisted exclusively of mono-disciplinary PRM. • The proxy "health status" (“ASA” proxy): a greater proportion of persons in poorer physical health was noted among persons receiving multi-disciplinary rehabilitation with PT (mixed); • Benefiting from compensation because of work incapacity attributable to disease or injury: fewer persons unable to work among mixed rehabilitations with multi-disciplinary PRM; • Persons not entitled to “minor risk coverage” were also more prominently represented in exclusive multi-disciplinary rehabilitation. 4.2.3.3 Health care consumption associated with rehabilitation episodes The study analysed the cost of other forms of health care covered by compulsory insurance which could be influenced or have an influence on the course of rehabilitation. See details in Appendix 18. Surgical trusses/orthopaedics This refers to orthopaedic materials, surgical trusses to the extent to which there is a high probability that they are specifically associated with the operation and intervention under study. There is no real difference in the frequency of consumption for surgical trusses/orthopaedics for the 5 types of rehabilitation. Medications This study makes no analysis of medications specifically associated with particular surgical procedures, in view of the work load involved for a relatively small return in terms of potential information. Consumption analysis relating to reimbursable analgesics and anti-inflammatory drugs indicates very little or no difference between the various types of rehabilitation.
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Het gebruik van kinesitherapie en van fysische geneeskunde ... - KCE

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