Personal perspectives on enablers and barriers to accessing care for hip and knee osteoarthritis

Ackerman, Ilana N., Livingston, Jenni A. and Osborne, Richard H. 2016, Personal perspectives on enablers and barriers to accessing care for hip and knee osteoarthritis, Physical therapy, vol. 96, no. 1, pp. 26-36, doi: 10.2522/ptj.20140357.

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Title Personal perspectives on enablers and barriers to accessing care for hip and knee osteoarthritis
Author(s) Ackerman, Ilana N.
Livingston, Jenni A.
Osborne, Richard H.ORCID iD for Osborne, Richard H.
Journal name Physical therapy
Volume number 96
Issue number 1
Start page 26
End page 36
Total pages 11
Publisher American Physical Therapy Association
Place of publication Alexandria, Va.
Publication date 2016-01
ISSN 1538-6724
Keyword(s) hip and knee osteoarthritis
joint replacement surgery
patient care
surgical treatment
Summary BACKGROUND: Despite increasing demand for joint replacement surgery and other health services for hip and knee osteoarthritis (OA), barriers and enablers to individual access to care are not well understood. A comprehensive understanding of drivers at all levels is needed to inform efforts for improving access. OBJECTIVE: The aim of this study was to explore perceived barriers and enablers to receiving conservative (nonsurgical) and surgical treatment for hip and knee OA. DESIGN: This was a qualitative study using directed content analysis. METHODS: Semistructured telephone interviews were conducted, with 33 participants randomly sampled from an Australian population-based survey of hip and knee OA. Each interview covered factors contributing to receiving treatment for OA and perceived barriers to accessing care. Interview transcripts were coded and organized into themes. RESULTS: Key barriers to accessing care for OA included medical opinions about saving surgery for later and the appropriate age for joint replacement. Other common barriers included difficulty obtaining referrals or appointments, long waiting times, work-related issues, and limited availability of primary and specialist care in some areas. Several participants perceived a lack of effective treatment for OA. Private health insurance was the most frequently cited enabler and was perceived to support the costs of surgical and conservative treatments, including physical therapy, while facilitating faster access to surgery. Close proximity to services and assistance from medical professionals in arranging care also were considered enablers. CONCLUSIONS: People with hip or knee OA experience substantial challenges in accessing treatment, and these challenges relate predominantly to health professionals, health systems, and financial factors. Private health insurance was the strongest perceived enabler to accessing care for OA.
Language eng
DOI 10.2522/ptj.20140357
Field of Research 111799 Public Health and Health Services not elsewhere classified
1103 Clinical Sciences
1106 Human Movement And Sports Science
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, American Physical Therapy Association
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Document type: Journal Article
Collection: Population Health
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