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126 APPENDICES Physiotherapy KCE reports vol. 40 XIII. Diseases of the musculoskeletal system and connective tissue VI. Diseases of the nervous system XIX. Injury, poisoning and certain other consequences of external causes XXI. Factors influencing health status and contact with health services XVIII. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified IX. Diseases of the circulatory system X. Diseases of the respiratory system V. Mental and behavioural disorders XIV. Diseases of the genitourinary system XVII. Congenital malformations, deformations and chromosomal abnormalities II. Neoplasms IV. Endocrine, nutritional and metabolic diseases I. Certain infectious and parasitic diseases XI. Diseases of the digestive system VIII. Diseases of the ear and mastoid process XV. Pregnancy, childbirth and the puerperium XVI. Certain conditions originating in the perinatal period XII. Diseases of the skin and subcutaneous tissue III. Diseases of the blood and blood-forming organs and certain disordes involving the immune mechanism XXII. Codes for special purposes XX. External causes of morbidity and mortality VII. Diseases of the eye and adnexa Figure 4.3 Number and proportion of reasons for treatment (RFT) according to the classification of the ICD-10 (n = 5449). Proportion of RFT in each ICD-10 chapter (%) 0 5 10 15 20 25 30 35 40 n = 5449 0 500 1000 1500 2000 Number of RFT in each ICD-10 chapter (n)
KCE reports vol. 40 APPENDICES Physiotherapy 127 The most common RFT classified in diseases of the nervous system included: Hemiplegia/hemiparesis (n = 200; 24 3% of the neurological diseases) Parkinson (n = 174; 21 3%) Multiple sclerosis (n = 83; 10 2%) Cerebral palsy (n = 69; 8 2%) The most common RFT classified in injury, poisoning and certain other consequences of external causes included: Sprain/strain of ankle (n = 58; 9 2% of the injuries) Spain/strain involving anterior or posterior cruciate ligament of knee (n = 55; 8 2%) Fracture of humerus (n = 52; 8 2%) Fracture of femur (n = 52; 8 2%) Other significant pathology categories included factors influencing health status and contact with health services (9.34 0.77%), symptoms/signs/abnormal clinical and laboratory findings not elsewhere classified (8.60 0.74%), diseases of the circulatory system (5.15 0.59%), and diseases of the respiratory system (4.77 0.57%). The most common RFT classified in factors influencing health status and contact with health services category was the presence of orthopaedic joints implants (n = 286; 57 4% of the pathology category), especially total hip (n = 134) and total knee replacement (n = 120). The most common RFT classified in symptoms/signs/abnormal clinical and laboratory findings not elsewhere classified category included gait disorders (n = 235; 53 5% of the pathology category), delayed milestone (n = 60; 13 3%), and balance disorders (n = 44; 10 3%). The most common RFT classified in diseases of the circulatory system included stroke/cerebrovascular disorders (n = 231; 53 5% of the circulatory diseases) and lymphoedema (n = 164; 37 5%; especially postmastectomy lymphoedema (n = 104)). The most common RFT classified in diseases of the respiratory system included COPD (n = 137; 53 6% of the respiratory disorders) and bronchitis/bronchiolitis (n = 66; 25 5%). Pathologies treated during ambulatory physiotherapeutic sessions, proportion of co-morbidity, and age and sex of the patients treated during these sessions are presented in Table 4.4 according to the pathology categories of the ICD-10. Data for the less represented pathology categories (particularly, from Mental/behavioural disorders to Codes for special purposes) must be interpreted with caution. The symptoms/signs/abnormal clinical and laboratory findings not elsewhere classified category and mental/behavioural disorders present the highest levels of co-morbidity indicating that it is relatively common to treat them with other conditions (32% and 23%, respectively). Note that gait disorders (i.e., symptoms/signs/abnormal clinical and laboratory findings not elsewhere classified category) are mainly combined with diseases of the musculoskeletal system and connective tissue. On average, the oldest people are treated by ambulatory physiotherapists for circulatory diseases (mean age: 70 years; high prevalence of stroke/cardiovascular disorders), factors influencing health status and contact with health services (mean age: 64 years; high prevalence of orthopaedic joints implants), symptoms/signs/abnormal clinical and laboratory findings not elsewhere classified (mean age: 63 years; high prevalence of gait disorders), respiratory diseases (mean age: 61 years; high prevalence of COPD), and neurological diseases (mean age: 60 years; high prevalence of hemiplegia/hemiparesis and Parkinson). On the contrary, youngest people are treated for mental/behavioural disorders (mean age: 27 years; high prevalence of developmental disorder of scholastic skills), congenital malformations/deformations/chromosomal abnormalities (mean age: 29 years; high prevalence of spina bifida and Down s syndrome), endocrine/nutritional/metabolic diseases, (mean age: 28 years; high prevalence of cystic fibrosis), certain conditions originating in the perinatal period and pregnancy/childbearing/puerperium disorders (mean age: 28 and 31 years, respectively). A very high prevalence of females is logically observed in pregnancy/childbearing/puerperium and genitourinary (higher prevalence of urinary incontinence) diseases. A higher prevalence of females is generally found in all pathology categories except in respiratory diseases in which there were little more males.
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