Healthcare reform is a hot topic right now. Congress has forced a government shut down because they believe that the Affordable Care Act (ACA) is bad policy. Yet, on October 1st, the Health Insurance Exchanges, a central component of the Individual Mandate opened for business making healthcare available to tens of millions of Americans who may have never had access to health insurance in their lifetime.
But, if you take away all the rhetoric and politics about healthcare reform, there are actually a few points that almost everyone can agree to:
- The U.S. has the greatest healthcare services in the world
- If we do nothing to fix the broken system in which we deliver these services, we will go broke
- The cost of healthcare in the U.S. is too high
Reducing healthcare costs in some ways is really simple, i.e. prevent people from getting sick or injured in the first place and they won't be utilizing resources, thus costs decrease. It sounds so easy.
One of the reasons the U.S. healthcare system is so expensive is its complexity. All of the players involved need to be committed to improving care and decreasing costs. Let's look at the role of physical therapists in this mix.
In July of this year, a team of more than 100 physical therapists met with legislators in Washington, D.C. to discuss the issues of reducing costs and the challenges facing their industry. They wanted to have an honest dialogue about healthcare reform and bring to light the ways in which physical therapists could help to solve some of the issues around this enormous problem.
Physical therapists are no different from most healthcare professionals. They simply want to deliver the best care to their patients.
Early Intervention and Treatment
Time and again, research has proven that if you see a patient early and get them the proper treatment, there is less cost to the system and to the patient. Unfortunately, there are close to 40 million people in this country who don't have health insurance and millions more who have very costly policies with high deductibles.
That typically results in people delaying diagnosis and treatment in the hope that their condition improves on its own. Even those with good health insurance worry about taking time off from work to see a doctor, so they too are delaying treatment.
But the research is compelling.
- For example, a May 2012 study published in Spine showed that early treatment by a physical therapist for low back pain (LBP), as compared to delayed treatment, was associated with reduced risk of subsequent healthcare utilization and lower overall healthcare costs.
- Another study conducted in April, and also published in Spine, also supported the benefits of early physical therapy for LBP. In this study, researchers found that patients who received physical therapy early (within 30 days) after an episode of acute low back pain had a lower risk of subsequent medical service usage (surgery or epidural steroid injections) than patients who received physical therapy later.
- The results of both of these studies were published by the American Physical Therapy Association (APTA).
- The APTA has also written a comprehensive report The Role of the Physical Therapist in Healthcare Reform which provides many suggestions and recommendations important to the industry.
- A 2007 study demonstrated that the length of stay for a group of respiratory-failure patients who received mobility therapy within 48 hours of the insertion of a breathing tube was reduced by an average of three days compared to the stay for patients who did not receive the therapy. This reduced length of stay included a reduction of time in the ICU of more than a day.
Therefore, it seems clear that if patients can be seen sooner rather than later, it can decrease the length of hospital stay and reduce the chance of developing chronic pain which means more expensive diagnostic exams and sometimes invasive treatments.
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