Organizing the flow of physiotherapy services: agreement between clinical perception and a referral protocol

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DOI:

https://doi.org/10.1590/fm.2021.34107

Keywords:

Physiotherapy. Health Regulation and Inspection. Primary Health Care. Secondary Health Care.

Abstract

Introduction: Protocols to organize the flow of treatment between primary and secondary healthcare levels help physiotherapists working in Primary Health Care (PHC) determine which cases will remain at the primary level and which should be referred to the secondary level for specialized treatment. Objective: Assess the agreement between the clinical perception of physiotherapists and the protocol in organizing the flow of physiotherapy patients. Method: This is a methodological cross-sectional study based on the analysis of secondary data, recorded on a service spreadsheet, with respect to the clinical perception of 4 physiotherapists working in PHC and the protocol they apply to determine the urgency for referral to the secondary care level, considering physiotherapy specialties. Assessment was expressed as the percentage agreement, magnitude and significance according to the Kappa test, with >0.80 considered perfect agreement. Analyses were conducted using SPSS 21.0 statistical software at a significance level of α= 0.05. Results: In 619 of 715 referrals, the perception of physiotherapists corroborated with the protocol in terms of patient referral to the secondary service. The percentage agreement for urgency classification in the total sample was 71% and the Weighted Kappa index 0.3710 (CI95% 0.3029-0.4391). The instrument exhibited high agreement in the areas of musculoskeletal physiotherapy (94.7%) and gerontology (98.2%), and low in urogynecology (27.6%). Conclusion: The protocol showed a high percentage of agreement and may be an important instrument in organizing the flow of physiotherapy services and could be enhanced for use in other specialties.

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Author Biographies

Lorrane Brunelle Moreira, Universidade Federal de Alfenas (UNIFAL-MG)

Fisioterapeuta, Mestranda do Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Alfenas (UNIFAL).

Fernanda Lurdes Souza Cruz, Universidade Federal de Alfenas (UNIFAL-MG)

Fisioterapeuta, Especialista em Saúde da Família pelo Programa de Residência Multiprofissional em Saúde da Família, Universidade Federal de Alfenas (UNIFAL).

Túlio Lima da Silva, Prefeitura Municipal de Alfenas

Enfermeiro, Coordenador de Atenção Básica, Prefeitura Municipal de Alfenas.

Silvia Lanziotti de Azevedo Silva, Universidade Federal de Juiz de Fora (UFJF)

Docente, Faculdade de Medicina/Departamento de Saúde Coletiva, Universidade Federal de Juiz de Fora (UFJF).

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Original Article

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