[Direct access to physiotherapy as a care model for Germany? A qualitative analysis of experts' perspectives on...

In some countries, direct access to physiotherapy for patients with musculoskeletal complaints has been introduced in order to ensure needs-based care. Patients can seek physiotherapy treatment directly without a doctor's prescription at the expense of their health insurance. Reviews show clinical advantages compared to referral-based access. The aim of this study was to investigate the need, possible care models and requirements for model projects of relevant stakeholders in Germany.

A qualitative study design was chosen to answer the research questions. Data collection involved a semi-structured, guide-assisted focus group and individual interviews on the perspectives of physiotherapy (n = 3), medicine (n = 3), patients (n = 2), payers (n = 4), politics (n = 2), and medical law (n = 2). Data were analyzed deductively-inductively using a thematic-structuring content analysis.

A total of 16 people took part in 11 individual interviews and one focus group (n = 5). All the perspectives planned were represented. The interview results indicate very heterogeneous views on the perceived need for and the design of direct access. Model projects are mainly considered necessary and should be conducted with comparable methodology in several German federal states in various settings.

In the German context, where there is disagreement among stakeholders about the need for direct access to physiotherapy, there is a nationwide need for research to clarify unresolved issues through pilot projects. This study provides an overview of the perspectives and thereby essential information for the further development of healthcare in Germany.