Margit Kooijman

Current care | 27 Using data from registration networks, the present study describes patient characteristics and the treatment process for patients treated by a representative group of GPs or physiotherapists who were unaware of the specific purpose of this study. In the Netherlands, patients can access physiotherapy professionals directly (known as direct access or self-referral) and it is known that use, treatment and outcome may differ depending on the mode of access 17 . However, it is not known whether this is also true for patients with shoulder syndromes specifically. By separating patients who were referred for physiotherapy from those who were not, an attempt was made to describe the care of the two groups and to deter- mine if they were materially different. In brief, the present study addresses two research questions. First, what are the characteristics of the patient population and the care process in patients with shoulder syndromes in general and in physiotherapy practice in particular? Second, does the population and care process differ between patients treated solely by their GP, those referred for physiotherapy and self-referrals? Methods Registration To describe patient characteristics and the process of care for patients with shoulder syndromes, data were used from the Netherlands Information Network of General Practice (LINH) 2 and the National Information Service for Allied Health Care (LIPZ) 1 . At the start of LINH, a random sample was drawn from the human resources register of GPs. Participating GPs record data on all patient contacts, including diagnoses, referrals and prescriptions. LIPZ is a registration network of physiotherapy practices that collects healthcare-related information on patient characteristics, mode of access, health problems and treatment plans on an ongoing basis. At the start of LIPZ, a random sample was drawn from the human resources register of physiotherapists. According to Dutch legislation entitled ‘Regulations on medical research involving human subjects’, ethical approval is required for medical research in which persons are subjected to treatment or are required to behave in a certain manner. As this was not the case for the present study, ethical approval was not necessary. Nevertheless, the Dutch Data Protection Authority was notified of the research. In addition, pursuant to the Personal Data Protection Act, data were collected anonymously, patients were informed about the research by posters and leaflets in practice waiting rooms and patients had the opportunity to refuse participation. The research was carried out in accordance with the Helsinki Declaration. Participants From the LINH database, all patients with shoulder syndromes, ICPC L92 (International Classification of Primary Care 18 who visited the GP in 2008 (n = 2428) were selected.