Presentation T P9
T P9 (Poster Presentation):
Physiotherapy professionals’ views of factors influencing quality of physiotherapy services for injured workers compensated by workers’ compensation in Quebec
- Programme de Sciences de la réadaptation, École de réadaptation, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
- Programmes de Bioéthique, Département de médecine sociale et préventive, École de santé publique, Université de Montréal, Montréal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
Physiotherapy professionals are implicated in the evaluation and treatment of persons with musculoskeletal injuries, a leading cause of work-related physical disability in Quebec. The Quebec Workers’ Compensation Board (CSST) recently implemented a strategic plan to increase accessibility and quality of care for their patients. However, in the physiotherapy domain, there is uncertainty regarding the quality of care provided to CSST patients. The main objective of this exploratory study was to examine quality of care and ethical issues encountered by physiotherapy professionals working with CSST patients.
We conducted a focus group study with physiotherapy professionals working in both the public and private sectors with CSST patients. Participants were recruited using a purposive sampling approach between May and September 2013. There were six physiotherapists in the first focus group (one male and five females) and seven physical rehabilitation therapy technicians in the second (two males and five females). Focus groups were recorded and transcribed verbatim. A thematic analysis was performed and ultimately, three central themes were developed.
These themes are: 1) systemic factors; 2) complexity in treatment decisions; and 3) inequalities of care. There appear to be differences with respect to the type and quality of services offered to CSST patients in comparison to other patients. For example, CSST patients are more likely to be treated by physical rehabilitation therapy technicians (who have a college level training in contrast to physiotherapists) and the duration of individual treatment sessions is often shorter. Lack of coordination, effective communication and psychological supports was also noted.
This study suggests that CSST patients are not always provided with optimal treatments due to systemic barriers to adequate care, raising equity concerns. These differences are partially related to financial incentives. Addressing systemic issues that limit quality of care is a pressing need. Renewed and productive dialogue between the CSST and physiotherapy professionals is required in order to improve patient care.
Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Social issues