After-hour physiotherapy services in a tertiary general hospital

The aims of the present study were to describe the after-hour physiotherapy services in a tertiary general hospital, the patients and their demographics, and to determine which independent variables would predict physiotherapists' referrals to after-hour physiotherapy. A retrospective record review from April 1, 2004, to April 30, 2005, identified 992 patients (mean age 63.8 years; 95% confidence interval [CI] 62.6-65.0 years) who were either referred by daytime physiotherapists (68%) or referred by medical practitioners for urgent attendance after hours (32%). Pneumonia was formally diagnosed medically in 20% (n=197) of the patients. Of all the patients who had surgery, upper abdominal or thoracic incisions formed the majority (61%; n=236). Whether patients had upper abdominal/thoracic surgery (estimated odds ratio 3.4; 95% CI 2.3-4.9) and the presence of pneumonia (2.8; 95% CI 1.9-4.2) were two independent factors identified from a logistic regression model predicting daytime physiotherapists' referral of patients to after-hour service. This model correctly predicted 65.5% of the cases. Most patients were seen for mucociliary clearance. Referral behaviour by physiotherapists reflects the basis of their clinical decision making and has implications for practice, training, and further research.