Research article

Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands: Cross sectional analyses of data from three clinical databases

Ilse CS Swinkels¹ , Dennis L Hart² , Daniel Deutscher³ , Wil JH van den Bosch⁴ , Joost Dekker⁵ , Dinny H de Bakker¹ and Cornelia HM van den Ende⁶

¹  NIVEL; Netherlands Institute for Health Services Research; P.O. Box 1568; 3500 BN Utrecht, The Netherlands

²  Focus On Therapeutic Outcomes, Inc., P.O. Box 114444, Knoxville, Tennessee 37939-1444, USA

³  Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv 68125, Israel

⁴  Radboud University Medical Centre, Department of General Practice; P.O. Box 9101; 6500 HB Nijmegen, The Netherlands

⁵  Department of Rehabilitation Medicine, EMGO Institute, VU University Medical Centre Amsterdam; P.O. Box 7057; 1007 MB Amsterdam, The Netherlands

⁶  Sint Maartenskliniek, Department of rheumatology; P.O. Box 9011; 6500 GM Nijmegen, The Netherlands

author email corresponding author email

BMC Health Services Research 2008, 8:163doi:10.1186/1472-6963-8-163

Published:	30 July 2008

Abstract

Background

Many assume that outcomes from physical therapy research in one country can be generalized to other countries. However, no well designed studies comparing outcomes among countries have been conducted. In this exploratory study, our goal was to compare patient demographics and treatment processes in outpatient physical therapy practice in the United States, Israel and the Netherlands.

Methods

Cross-sectional data from three different clinical databases were examined. Data were selected for patients aged 18 years and older and started an episode of outpatient therapy between January 1^st 2005 and December 31^st 2005. Results are based on data from approximately 63,000 patients from the United States, 100,000 from Israel and 12,000 from the Netherlands.

Results

Age, gender and the body part treated were similar in the three countries. Differences existed in episode duration of the health problem, with more patients with chronic complaints treated in the United States and Israel compared to the Netherlands. In the United States and Israel, physical agents and mechanical modalities were applied more often than in the Netherlands. The mean number of visits per treatment episode, adjusted for age, gender, and episode duration, varied from 8 in Israel to 11 in the United States and the Netherlands.

Conclusion

The current study showed that clinical databases can be used for comparing patient demographic characteristics and for identifying similarities and differences among countries in physical therapy practice. However, terminology used to describe treatment processes and classify patients was different among databases. More standardisation is required to enable more detailed comparisons. Nevertheless the differences found in number of treatment visits per episode imply that one has to be careful to generalize outcomes from physical therapy research from one country to another.