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132 APPENDICES Physiotherapy KCE reports vol.40 Table 5 Comparison between the nomenclature data of the survey and those of the INAMI/RIZIV (2004) (continued) Belgian nomenclature data Survey* INAMI/RIZIV* Comparison Difference** (n = 5 244) (n = 29 198 425) Statistic p-value Fees cost ² = 508.27, df = 10 < 0.001 05.39 102 (1.95 ± 0.37%) 1063906 (3.64 ± 0.01%) 1.69% z = 06.53 < 0.001 06.74 43 (0.82 ± 0.24%) 599725 (2.05 ± 0.01%) 1.23% z = 06.25 < 0.001 08.76 167 (3.18 ± 0.47%) 2324357 (7.96 ± 0.01%) 4.78% z = 12.75 < 0.001 09.77 217 (4.14 ± 0.54%) 1060083 (3.63 ± 0.01%) 0.51% z = 01.93 0.054 10.87 26 (0.50 ± 0.19%) 254276 (0.87 ± 0.00%) 0.37% z = 02.85 0.004 16.17 0 (0.00 ± 0.00%) 616 (0.00 ± 0.00%) 0.00% z = -01.17 0.242 16.66 541 (10.32 ± 0.82%) 3704836 (12.69 ± 0.01%) 2.37% z = 05.14 < 0.001 17.00 798 (15.22 ± 0.97%) 5448304 (18.66 ± 0.01%) 3.44% z = 06.38 < 0.001 18.00 3323 (63.37 ± 1.30%) 14532748 (49.77 ± 0.02%) 13.60% z = 19.68 < 0.001 25.96 1 (0.02 ± 0.04%) 85728 (0.29 ± 0.00%) 0.27% z = 03.55 < 0.001 30.32 26 (0.50 ± 0.19%) 123846 (0.42 ± 0.00%) 0.08% z = 00.69 0.489 * Number of nomenclature codes (proportion ± accuracy corresponding to the 95% confidence interval) ** Proportion ² = Chi-Square Test; df = degree of freedom; z = z-test.
KCE reports vol. 40 APPENDICES Physiotherapy 133 Significant differences between questionnaire and INAMI/RIZIV data were observed for all variables of the Belgian nomenclature code. However, the differences of proportions seen between questionnaire and INAMI/RIZIV data are generally small. Overall, a difference of proportions equivalent to 2.25 ± 3.06% was found. Codes relative to physiotherapists office were more represented in the questionnaire to the detriment of patients home and nursing home codes. There were also more codes referring to a session length of 30 minutes to the detriment of the other lengths. Heavy pathologies were less recorded in our questionnaire. On the contrary, acute and chronic pathologies of FA and FB lists were more represented. Finally, there were more codes relative to fee cost of 18 euros to the detriment of other costs. 1.2.3. Treatment modalities applied in Belgium ambulatory physiotherapy Treatment modalities applied in Belgian ambulatory physiotherapy were recorded by asking the physiotherapists who have treated, last week, at least one patient suffering from the selected condition to indicate the treatment modality/ies applied for the last patient seen for this condition. The age and sex of this patient as well as the delay between the beginning of his/her condition and the beginning of the treatment by the physiotherapist were recorded. The respondents also had the possibility to specify the electrophysiotherapeutic modalities and other treatment modalities not included in the pre-established list (in this case, the treatment modality was labelled as Added treatment: X , where X is the name of the treatment modality). Table 4.6 presents, for each condition selected in the questionnaire, the number and proportion of physiotherapists who have treated in the week preceding the receipt of the questionnaire at least one patient of the selected condition as well as the age and sex of the last patient seen for this condition. Table 6 Treatment modalities applied in Belgium ambulatory physiotherapy Physiotherapists Patients' characteristics Conditions selected in the survey treating at least 1 case/week* Age (years)** Sex*** Acute low back pain (without radiating pain) 255 (69 ± 05%) 46 ± 16 (05-092) 126 (50 ± 06%) Total knee replacement 172 (47 ± 05%) 69 ± 10 (42-090) 045 (28 ± 07%) Hemiplegia/hemiparesis 255 (69 ± 05%) 68 ± 16 (02-098) 142 (58 ± 06%) Gait disorders in elderly people 266 (72 ± 05%) 81 ± 07 (62-100) 062 (25 ± 05%) Bronchiolitis in infants and children 090 (25 ± 04%) 02 ± 03 (00-013) 047 (55 ± 11%) * Number of physiotherapists (proportion ± accuracy corresponding to the 95% confidence interval) ** Mean ± SD (minimum-maximum) *** Number of males (proportion ± accuracy corresponding to the 95% confidence interval) Acute low back pain (without radiating pain) Overall, 255 physiotherapists out of the 367 respondents have treated, in the week preceding the receipt of the questionnaire, at least one patient suffering from acute low back pain without radiating pain (see Table 4.6). Distribution of patients age, proportion of males and females, repartition of the delays between the beginning of the complaint and the beginning of the treatment by the physiotherapist, and distribution of treatment modalities are presented in Figure 4.4. Low back pain concerns all age brackets with a predominance in the adulthood. As shown in Table 4.6, the patients mean age was 46 ± 16 years (range: 5 92 years). The prevalence of males and females were similar. The delays between the beginning of the complaint and the beginning of the treatment by the physiotherapist were varied: immediate, 1 week, 2 weeks, 3 weeks, or over 1 month. The most frequent treatment modalities applied by Belgian ambulatory physiotherapists to treat patients with acute low back pain were, from the most prevalent to the least: education of the patient (information, advices) (86 ± 04%), massage (75 ± 05%), mobilizations (74 ± 05%), home exercises (62 ± 06%), and stretching (55 ± 06%). The following treatment modalities were also common: thermotherapy (46 ± 06%), muscle strengthening (44 ± 06%), electrophysiotherapy (39 ± 06%; the most frequent electrophysiotherapeutic
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