ESPE Abstracts

Background: Physical therapy plays a critical role in the multidisciplinary care of patients with rare bone disorders, such as osteogenesis imperfecta (OI). In Austria, similar to other European regions, the majority of OI patients depend on the availability of extramural (outpatient) therapists for their physical therapy needs. However, access to these therapists can be hindered by several factors, including long waiting times and the lack of coverage under public insurance schemes. Structured data regarding the accessibility and the challenges faced in obtaining extramural physical therapy are not available to the authors' knowledge.

Purpose: This study aims to provide a detailed depiction of access to physical therapy for pediatric patients with OI in Austria, serving as a representative sample for similar regions.

Methods: A standardized inquiry was sent to physical therapists listed in the official Austrian registry (PhysioAustria). The inquiry involved a hypothetical consultation request for a five-year-old child diagnosed with OI type I. Key parameters assessed included the availibilty of treatment on a public insurance plan, the waiting time for the first available appointment, the cost of treatment with an emphasis on identifying regional disparities in these parameters.

Results: Out of 675 extramural physiotherapists with focus on pediatric patients across Austria, 24 physiotherapists (4%) offered appointments covered by public health insurance, with an average waiting time of 40 days. The majority of therapists (341, 51%) rejected to provide any appointment. Notably, 13% of the contacted therapists declined to provide any appointment due to the specific diagnosis of the sample patient, while the remaining therapists declined for other or unspecified reasons. In total 334 physiotherapists (49%) offered private appointments, with an average waiting time of 31 days and median costs of €100 per session (Mean €101, range €48-240).

Discussion: The findings of this study highlight significant challenges faced by families of children with OI in accessing essential physical therapy services. Profound challenges, characterized by long waiting times and high out-of-pocket costs, may impede children from receiving timely and necessary treatments, potentially leading to adverse physical and mental health outcomes. Despite regional differences in healthcare systems, similar access issues are likely present in other European regions. The ultimate goal of this data assessment to advocate for policy changes and resource allocation that improve access to essential physical therapy services, ensuring that patients with OI and similar conditions receive the comprehensive care they need to optimize their quality of life.