Role of the Physiotherapist in the Orthopaedic Trauma Department in the Context of National Health Fund Funding of Medical Procedures

Abstract

The present paper aims to demonstrate that physiotherapy in orthopaedic and trauma departments is part and parcel of a comprehensive treatment plan. Hospital records of 66 patients treated in three orthopaedic trauma departments in 2011 were analysed. Basing on the requirements of the National Health Fund (Narodowy Fundusz Zdrowia--NFZ), reports were generated on the number of physiotherapy procedures provided. The mean age of the patients was 70.26 (SD=12.08) years. Sixty-two of them (93.94%) had undergone hip replacement and the remaining 4 (6.06%) had undergone knee replacement procedures. The patients spent a mean of 13 days in hospital (SD=3.66, range 9-30 days). The following physiotherapy procedures were applied: mobilisation in 48 subjects (72.73%), seating in 47 (71.21%), gait training in 48 (72.73%), exercises of the affected leg in 46 (69.70%), upper limb exercises in 38 (57.58%) and breathing exercises in 28 (42.42%). According to the NFZ regulations, the maximum number of patients per one physiotherapist in an orthopaedic department is 10, which requirement was met in only one of the three hospitals involved. 1. Arthroplasty procedures along with long bone fracture fixation are the most common causes of hospitalisation in orthopaedic trauma departments. 2. The departments involved in this study do not provide pre-operative rehabilitation. Physiotherapy begins at 3 days post surgery. 3. Most of the departments involved do not comply with the NFZ's requirement regarding the therapist-to-patient ratio.