What factors affect attendance at musculoskeletal physiotherapy outpatient services for patients from a high deprivation area in New Zealand?

Abstract

Barriers to accessing health services in New Zealand may manifest in inequalities. This study explored barriers and facilitators to accessing a District Health Board funded musculoskeletal physiotherapy outpatient service situated in two different geographical locations. Participants were purposely and then systematically selected from attendance records, were aged 18 years and older, had failed to attend one or more physiotherapy musculoskeletal outpatient sessions at either location, and lived in a geographical area considered high deprivation. Semi-structured interviews were audio-recorded, transcribed, and analysed using the General Inductive Approach. Seventeen participants with diverse ethnic backgrounds aged between 22 and 67 years were recruited. Four barriers (‘Placing value on the unknown’, ‘Divergent health beliefs’, ‘Appropriateness of physiotherapy’, ‘Waiting times’) and three facilitators (‘Convenience’, ‘Privacy’, ‘Physiotherapy works’) were identified. No barrier was identified as being more problematic at either clinic site. Participants believed physiotherapy was beneficial. However, uncertainty regarding the aims of physiotherapy affected participants’ ability to value its worth and affected attendance. Convenience of location influenced attendance of people living in a high deprivation area.