Use of primary healthcare services before and after specialized rehabilitation and its relation to changes in health and functioning: a longitudinal cohort study.
Anne Mette Berget, Vegard Pihl Moen, Merethe Hustoft and 4 others
PMID 39161992WHAT IT FOUND
Patients used more GP and physiotherapy services before specialized rehabilitation, then visits gradually decreased.
Those reporting poorer health used services more frequently, but high use did not guarantee better long-term functioning. This reflects service patterns, not treatment effectiveness.
Key findings
01There was an increase in GP and PT visits leading up to rehabilitation, followed by a gradual decrease after rehabilitation in the total cohort.
02Participants with 3 or more GP visits tended to have lower scores on the EQ-VAS at both follow-ups than participants with 0–2 GP visits.
03A higher frequency of PHC use did not appear to result in greater long-term improvement in self-reported health and functioning for all participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study did not investigate the specific rehabilitation interventions provided, so it cannot link outcomes to particular treatments. The sample size for specific diagnostic subgroups was relatively small, preventing comparisons between other diagnostic groups. Data on specialist healthcare use after rehabilitation was missing, meaning some patients, particularly those with cardiovascular conditions, may have received care outside primary healthcare that was not counted. Participants lost to the 3-year follow-up were younger, more often female, and had different baseline health profiles, which may bias the long-term results. The study relied on register data for visits, which confirms contact occurred but does not capture the quality or content of those visits.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Western Norway Regional Health Authority.
The easy way to misread this
Do not interpret the decrease in PT visits after rehabilitation as a failure of the primary care system or a lack of need. The study shows this pattern alongside stable or improved self-reported functioning, suggesting that reduced service use may reflect patients coping better or needing less intensive support, not necessarily unmet needs.