Physiotherapy access for children and adolescents with physical disabilities in public institutions

Abstract This study aims to identify the factors that hinder physically disabled children and adolescent’s access to physiotherapy in establishments accredited by the Unified Health System in Curitiba, Paraná, Brazil. This is a cross-sectional study that interviewed managers, physiotherapists, parents or guardians of children with physical disabilities. The perception of difficulties of each interviewed group was compared through descriptive statistics, considering the following realms: availability, purchasing power, information and acceptability. Considering the realm of availability, we identified the following hindrances: distance between the physiotherapy location and user’s residence, inadequate supply of services and waiting list. Regarding the purchasing power, we observed the lack of financial resources among parents. Regarding information and acceptability, the lack of information about diagnosis and denial were reported by participants. We can conclude that the physiotherapy service has not been timely assured to children’s motor development, so it is necessary to review the organization and distribution of services, and effective policies are required to ensure their use.摘要：本研究旨在探明巴西巴拉那州库里提巴市经统一卫生系统（Unified Health System）认证的医疗机构中，阻碍肢体残障儿童及青少年接受物理治疗的相关影响因素。本研究为横断面研究，访谈对象涵盖管理人员、物理治疗师以及肢体残障儿童的父母或法定监护人。研究采用描述性统计学方法，对比各组受访对象所感知到的就诊阻碍，并从可及性、经济购买力、信息获取度与服务可接受性四个维度展开分析。在可及性维度下，本研究识别出的阻碍因素包括：物理治疗机构与服务使用者住所间距过远、服务供给不足以及排队等候时长过长。在经济购买力维度方面，研究发现患儿父母普遍存在经济资源匮乏的问题。在信息获取与服务可接受性维度中，受访对象提及存在诊断信息缺失以及服务被拒的情况。综上，当前物理治疗服务未能及时保障儿童的运动发育需求，因此有必要对服务的组织架构与资源分配模式进行优化调整，并需出台有效政策以确保服务得到有效利用。