Background: In the Republic of Ireland, physiotherapy for low back pain (LBP) is delivered in both public and private sectors via hospital-based departments (H) and community-based private practices (P) respectively. However, there is inequity in access and minimal evidence of the physiotherapy management of LBP in these two settings.
Purpose: To investigate any differences in patient profile and physiotherapy management of LBP in H and P settings.
Methods: A random sample of one Dublin city hospital and neighbouring private practices (n=3) were recruited. A retrospective chart survey of all LBP patients who commenced physiotherapy during 2003 was conducted. Data were analysed using Statistical Package for Social Sciences (SPSS, v.11). Ethical approval was granted by the participating hospital.
Results: In total, 249 charts were identified: H=93 [male n=32, female n=61, mean age (SD) = 46 years (20)]; P =156 [male n=78, female n=78, mean age (SD) = 36 years (10)]. Statistically significant differences between settings were found for:
percentage of patients with ‘acute’ (<
12 weeks) and ‘chronic’ (≥12 weeks) LBP [H: acute LBP = 4.7%, chronic LBP = 95.3%; P: acute LBP= 84.7%, chronic LBP= 15.3%; χ2 = 120.34, df=1, p<
0.001];
mean number of treatments [H=5 treatments (SD=3.8); P=2.5 treatments (SD=2); t = −6.0, df = 123, p<
0.0001];
median duration of treatment [H=6 weeks (IRQ=4-12); P=1 week (IRQ=0.14-2) p<
0.0001].
Conclusion: Findings suggest a two-tier system of health care for LBP patients in Ireland. A randomised controlled trial evaluating patient outcomes in both settings is currently underway by the Research Team.
