The Consequences of Delisting Publicly Funded, Community-Based Physical Therapy Services in Ontario: A Health Policy Analysis

Abstract

Purpose: Because publicly-funded, community-based physical therapy (PT) services through Ontario's network of Schedule 5 providers were partially delisted in April 2005, we examined the perceived consequences of this policy decision among different provider categories following partial delisting. Schedule 5 providers or clinics, renamed “Designated Physiotherapy Clinics” following partial delisting, are privately-owned and operated facilities that have agreements with Ontario's Ministry of Health and Long-Term Care to deliver publicly funded services for eligible clients. Methods: A health policy research approach used semi-structured telephone interviews with 33 physical therapists from Schedule 5 clinics, home care settings, hospitals, and private clinics within the Greater Toronto Area and across Ontario. Results: Schedule 5 providers perceived an immediate decrease in demand, whereas PT providers from other categories reported no change at the time of interview. Conversely, all providers forecasted decreased access for ineligible clients but a potential for improved access and reduced wait times among those who remained eligible. In the final analysis, PT informants in all categories agreed that partial delisting was an improved policy decision compared with full delisting, as proposed initially. Conclusions: Perceived consequences appeared to depend on provider type. However, informants from all provider categories cautioned that this policy decision would have a significant impact on the health status of some Ontarians. Further research is warranted to explore the long-term effects of this policy decision.