Domiciliary physiotherapy: cost and benefit

Abstract

This report describing the study of domiciliary physiotherapy within the South Birmingham Health District covers the period August 1977 to December 1980 inclusive, when six hundred patients completed a course of physiotherapy treatment. Related investigations, involving a further four hundred and eighty-eight patients,are described, including the developments in the service during 1980. The aim of the study was to evaluate a domiciliary physiotherapy service in terms of its effectiveness, the costs involved, to relate these costs to output, and to determine whether there were particular client groups for whom such a service would be most suitable. Patients were assigned to one of three groups; domiciliary treatment group, hospital based treatment group, and no treatment group. Assessments, questionnaires, content analysis, VTR and various physical measurements were used in the investigation. Results obtained during the course of the study show that physiotherapy treatment in the patient's home is generally as effective as that given in the hospital physiotherapy department.For certain groups of patients the costs incurred in a domiciliary physiotherapy treatment were similar to those incurred in a hospital based treatment, although patients requiring ambulance transport for treatment cost three times as much as the equivalent domiciliary treatment. This study has demonstrated that a domiciliary physiotherapy service is a cost effective way of providing a physiotherapy service to certain groups of patients, the elderly, the young chronic sick, the terminally ill who wish to remain at home, certain orthopaedic post-operative patients and patients who have suffered a cerebral vascular accident. It has also been shown that minimal support to relatives has been instrumental in keeping the patient at home and out of the hospital.