# USE OF PRIMARY HEALTHCARE SERVICES BEFORE AND AFTER SPECIALIZED REHABILITATION AND ITS RELATION TO CHANGES IN HEALTH AND FUNCTIONING: A LONGITUDINAL COHORT STUDY

## TL;DR

This study found that healthcare visits before and after rehabilitation relate to health improvements, but other factors also influence long-term recovery.

## Contribution

The study reveals how primary healthcare use before and after rehabilitation correlates with health outcomes in different patient groups.

## Key findings

- GP and PT visits increased before rehabilitation and decreased afterward, except for CVD patients.
- Lower health and functioning were linked to more frequent PHC visits after rehabilitation.
- Certain subgroups showed clinically important improvements based on healthcare use patterns.

## Abstract

To examine patients’ use of primary healthcare (PHC) before and after specialized rehabilitation and its relation with self-reported health and functioning.

Longitudinal cohort study.

451 rehabilitation patients.

Register data were used to measure the frequency of visits to the general practitioner (GP) and physiotherapist (PT) in PHC 3 years before and after rehabilitation. Patients reported health (EQ-VAS) and functioning (SF-36) before rehabilitation and at 1 and 3 years after. Data are described for the total study cohort and subgroups with musculoskeletal disease (MSD) and cardiovascular disease (CVD).

There was an increase in GP and PT visits preceding rehabilitation and a gradual decrease thereafter. An exception was GP visits among patients with CVD, with few diagnosis-specific visits before but an increase after. Lower levels of health and functioning tended to be related to more frequent GP and PT visits. An indication of clinically important improvement was found among those with frequent GP visits in the MSD subgroup, and among those with 1–2 GP visits in the CVD subgroup.

The diverse relationship between health and functioning, and the use of PHC services at follow-up, may imply that additional factors besides healthcare use explain long-term improvement following rehabilitation.

In this study, we included 451 rehabilitation patients and examined their use of primary healthcare 3 years before and after specialized rehabilitation and its relation with self-reported health and functioning. We found an increase in visits to the general practitioner (GP) and physiotherapist (PT) leading up to rehabilitation and a gradual decrease thereafter. An exception was GP visits among patients with cardiovascular diagnoses. They had few visits specific to the diagnosis before rehabilitation followed by an increase after. There seemed to be a trend that patients with lower levels of self-reported health and functioning had a higher frequency of primary healthcare use after rehabilitation. The group with frequent GP visits in the musculoskeletal subgroup and those with 1–2 GP visits in the cardiovascular subgroup had a tendency for greater clinically important improvement. Results may imply that additional factors besides healthcare use explain long-term improvement following rehabilitation.