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124 APPENDICES Physiotherapy KCE reports vol.40 Table 3 Physiotherapeutic sessions during one working day (sessions, co-morbidity, patients' characteristics) ICPC-2 Chapter Reason(s) for treatment Patients' characteristics Sessions* Co-morbidity* Age** Sex* (years) (males) L. Musculoskeletal 2696 (49.78 ± 1.33%) 139 (05 ± 01%) 53 ± 20 (00-101) 1011 (38 ± 02%) N. Neurological 1158 (21.38 ± 1.09%) 127 (11 ± 02%) 64 ± 23 (00-098) 473 (41 ± 03%) A. General and unspecified 506 (9.34 ± 0.77%) 47 (09 ± 02%) 64 ± 18 (02-101) 168 (33 ± 04%) K. Cardiovascular 466 (8.60 ± 0.75%) 38 (08 ± 02%) 69 ± 13 (24-099) 146 (31 ± 04%) R. Respiratory 279 (5.15 ± 0.59%) 20 (07 ± 03%) 59 ± 29 (00-099) 150 (54 ± 06%) P. Psychological 132 (2.44 ± 0.41%) 29 (22 ± 07%) 26 ± 31 (00-094) 77 (58 ± 08%) U. Urological 44 (0.81 ± 0.24%) 2 (05 ± 06%) 48 ± 19 (07-081) 4 (09 ± 08%) W. Pregnancy, childbearing, family planning 34 (0.63 ± 0.21%) 1 (03 ± 06%) 31 ± 04 (25-039) 0 (00 ± 00%) T. Endocrine / metabolic and nutritional 26 (0.48 ± 0.18%) 2 (08 ± 10%) 28 ± 25 (01-090) 12 (46 ± 19%) X. Female genital 26 (0.48 ± 0.18%) 2 (08 ± 10%) 53 ± 17 (21-092) 0 (00 ± 00%) S. Skin 21 (0.39 ± 0.17%) 3 (14 ± 15%) 45 ± 25 (02-083) 9 (43 ± 21%) D. Digestive 12 (0.22 ± 0.12%) 4 (33 ± 27%) 49 ± 23 (18-083) 6 (50 ± 28%) H. Ear 6 (0.11 ± 0.09%) 1 (17 ± 30%) 50 ± 26 (04-079) 3 (50 ± 40%) Y. Male genital 6 (0.11 ± 0.09%) 0 (00 ± 00%) 65 ± 07 (53-070) 6 (100 ± 00%) B. Blood, blood forming organs and immune mechanism 3 (0.06 ± 0.07%) 1 (33 ± 53%) 54 ± 43 (04-083) 2 (67 ± 53%) Z. Social problems 1 (0.02 ± 0.04%) 0 (00 ± 00%) 91 ± 00 (91-091) 1 (100 ± 00%) F. Eye 0 (0.00 ± 0.00%) - - - Total 5416 (100 ± 0.00%) 416 (08 ± 00%) 57 ± 23 (00-101) 1968 (36 ± 00%) * Number (proportion ± accuracy corresponding to the 95% confidence interval) ** Mean ± SD (minimum - maximum)
KCE reports vol. 40 APPENDICES Physiotherapy 125 On average, the oldest people are treated by ambulatory physiotherapists for cardiovascular (mean age: 69 years; high prevalence of stroke/cardiovascular disorders), male genital (mean age: 65 years; high prevalence of prostatectomy), and neurological (mean age: 64 years; high prevalence of gait disorders, hemiplegia/hemiparesis, and Parkinson) disorders as well as for general and unspecified conditions (mean age: 64 years; high prevalence of orthopaedic joint implants). On the contrary, youngest people are treated for psychological (mean age: 26 years; high prevalence of delayed milestone and learning problems), endocrine/metabolic/nutritional (mean age: 28 years; high prevalence of cystic fibrosis), and pregnancy/childbearing/family planning (mean age: 31 years) conditions. A very high prevalence of females is logically observed in pregnancy/childbearing/family planning, female genital, and urological (higher prevalence of urinary incontinence) conditions while, of course, male genital category concerns exclusively males. A higher prevalence of females is also found in the pathology categories that mainly affect older people presumably due to the higher life expectancy of females. Information that results from Belgian nomenclature codes (i.e., place of the rehabilitation, length of the session, type of pathology treated, and fee cost of the session) is presented in Appendix 4.H. Pathology categories primarily treated in physiotherapists office are musculoskeletal, psychological, urological, and pregnancy/childbearing/family planning conditions. Neurological and respiratory disorders are more frequently treated in patients home. Overall, the mean length of a session is 29 ± 4 minutes. Thirty minutes are the most frequent length observed in the questionnaire. Almost no sessions were allocated for consultative examination and written report (see Section 4.2.2.3). A high prevalence of common pathologies is observed in musculoskeletal and urological disorders. Heavy pathologies are generally encountered in neurological (high prevalence of hemiplegia/hemiparesis, Parkinson, multiple sclerosis, and cerebral palsy) and cardiovascular (high prevalence of stroke/cardiovascular diseases) disorders. Perinatal pathologies logically concern pregnancy/childbearing/family planning conditions. Pathologies of acute FA list are frequent in general and unspecified conditions (high prevalence of orthopaedic joint implants) and, to a lesser extent, in musculoskeletal disorders (due to the prevalence of fractures, sprain/strain of knee, internal derangement of knee, and rotator cuff syndrome). Pathologies of chronic FB list are mainly encountered in psychological conditions (high prevalence of learning problems and delayed milestone) and, to a lesser extent, in neurological disorders (high prevalence of gait disorders). Finally, fee cost for a session is on average equivalent to 16.72 ± 3.12 euros; 18.00 euros being the most frequent fee cost observed in the questionnaire. Physiotherapeutic Statistical Classification of Diseases and Related Health Problems 10 th Revision (ICD-10) As formulated in the previous section, one physiotherapeutic session may be used to treat more than one condition when co-morbidity exists. In such situation, the session was divided into the number of RFT/conditions that are treated during this session if they belong to different ICD-10 chapters. As a result, the 5170 examined sessions increased up to 5449 reasons for treatment. The number and the proportion of RFT according to each of the 21 ICD-10 chapters are illustrated in Figure 4.3. Most of the pathologies treated in Belgium during ambulatory physiotherapeutic sessions refer to diseases of the musculoskeletal system and connective tissue (37.62 1.29%), diseases of the nervous system (15.34 0.96%), and injury, poisoning and certain other consequences of external causes (12.48 0.88%). The most common RFT classified in diseases of the musculoskeletal system and connective tissue included: Low back pain (n = 332; 16 2% of the musculoskeletal diseases) Arthosis/polyarthrosis (n= 245; 12 2%) Cervicalgia (n = 204; 10 1%) Enthesopathy/tendinitis (n = 169; 8 1%) Adhesive capsulitis of shoulder (n = 119; 6 1%) Internal derangement of knee (n = 99; 5 1%) Dorsalgia (n = 95; 5 1%)
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