Monitoring physiotherapy using a national registration network Summary

The focus of this thesis is on transparency of physiotherapy care. As described in Chapter 1, the need for transparency and accountability in physiotherapy, as in other professions, has been growing in recent decades. This need has been fuelled by changes in the health care system. Under the current system, health care providers themselves are responsible for insight into their quality management; patients have greater responsibility, influence and choice; and health care insurers negotiate with health care providers on the price, content and organisation of care. Transparency of care enables the government which remains responsible at system level for the accessibility, affordability and quality of care to keep an overview of the provided health care, obtain insight into the quality of care and monitor the effects of policy measures. In a system with more transparency, providers can more easily compare their own care supply to that of others; and health care insurers gain insight into the health care they are insuring. Patients need transparency of care to be able to choose the best available care provider. Information from patient administration can contribute to transparency of health care. Current developments in computerisation leading to increased use of electronic medical records (EMRs) provide new opportunities for health care research and transparency of care. EMRs are easily accessible, and by aggregating and merging EMR elements from several practices, clinical databases can be formed in a relatively easy manner. In 2001, in the Netherlands one such clinical database was established: the National Information Service for Allied Health Care (LiPZ). LiPZ is aimed at a continuous supply of health care related information on physiotherapy. For the purpose of this thesis, LiPZ data were used to contribute to transparency of quality, transparency of changes over time, transparency of outcome, and transparency