Concordance between physiotherapists and physicians for care of patients with musculoskeletal disorders presenting to the emergency department
| Autor: | Alice Aiken, M. Ambrosio, Eveline Matifat, B. Hamelin, Véronique Lowry, François Desmeules, M. Mequignon, Kadija Perreault, Simon Décary, E. Gagnon, Jean-Sébastien Roy, Lisa C. Carlesso, N. Farley, D. Pelletier |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Canada medicine.medical_specialty Concordance lcsh:Special situations and conditions Musculoskeletal disorders Patient Care Planning 03 medical and health sciences 0302 clinical medicine Patient satisfaction Treatment plan Physicians Health care Chi-square test Humans Physiotherapist Medicine Musculoskeletal Diseases 030212 general & internal medicine Aged 030203 arthritis & rheumatology Modalities Emergency department business.industry lcsh:RC952-1245 lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 Overcrowding Middle Aged Primary care Physical Therapists Patient Satisfaction Family medicine Emergency Medicine Female Emergency Service Hospital business Research Article |
| Zdroj: | BMC Emergency Medicine, Vol 19, Iss 1, Pp 1-10 (2019) BMC Emergency Medicine |
| ISSN: | 1471-227X |
| DOI: | 10.1186/s12873-019-0277-7 |
| Popis: | Background Overcrowding in emergency departments (ED) is a major concern worldwide. To answer increasing health care demands, new models of care including advanced practice physiotherapists (APP) have been implemented in EDs. The purpose of this study was to assess diagnostic, treatment and discharge plan concordance between APPs and ED physicians for patients consulting to the ED for minor musculoskeletal disorders (MSKD). Methods Patients presenting to two EDs in Montréal (Canada) with a minor MSKD were recruited and independently assessed by an APP and ED physician. Both providers had to formulate diagnosis, treatment and discharge plans. Cohen’s kappa (κ) and Prevalence and Bias Adjusted Kappas (PABAK) with associated 95%CI were calculated. Chi Square and t-tests were used to compare treatment, discharge plan modalities and patient satisfaction between providers. Results One hundred and thirteen participants were recruited, mean age was 50.3 ± 17.4 years old and 51.3% had an atraumatic MSKD. Diagnostic inter-rater agreement between providers was very good (κ = 0.81; 95% CI: 0.72–0.90). In terms of treatment plan, APPs referred significantly more participants to physiotherapy care than ED physicians (κ = 0.27; PABAK = 0.27; 95% CI: 0.07–0.45; p = 0.003). There was a moderate inter-rater agreement (κ = 0.46; PABAK = 0.64; 95% CI: 0.46–0.77) for discharge plans. High patient satisfaction was reported with no significant differences between providers (p = 0.57). Conclusion There was significant agreement between APPs and ED physicians in terms of diagnosis and discharge plans, but more discrepancies regarding treatment plans. These results tend to support the integration of APPs in ED settings, but further prospective evaluation of the efficiency of these types of models is warranted. |
| Databáze: | OpenAIRE |
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