Factors associated with access to physical therapy, speech therapy or occupational therapy services in people with cerebral palsy from Bucaramanga and metropolitan area

INTRODUCTION: Accessibility to health services should ensure timely and full care. For People with Cerebral Palsy (PCP) access may be influenced by the organization services, relationships between population, insurers and health care providers. We describe the factors that influence access to physical rehabilitation services by the General Social Security System (GSSS) in Health of the PCP of Bucaramanga and its metropolitan area, 2013. 

METHODS: A case-control study was performed. The sample included 180 PCP aged between 0 to 60. Case were those in the last year did not belong to the GSSS in either regimes or uninsured poor, or those in the last year belonged to GSSS but they unused these services through GSSS. Controls were those belonged to the GSSS and used it in the last year at least once to any of the services evaluated. The information was collected between December 2012 to August 2013 using a structured questionnaire and physiotherapy assessment. Multivariable logistic regression analyses tested whether the effects of variables on access. 

RESULTS: There were significant association with the interaction incomeXaccessible transportation (OR 0,31; 95% CI 0.12-0.77), health regime or uninsured poor (OR = 7.14; 95% CI 2.78-18.34), take legal action (OR 0.12; 95% CI 0,05-0,30); 5-15 sessions in the last week (OR = 0.16; 95% CI 0.06-0.38); delay in the appointments (OR = 4.91; 95% CI 1.91-12.59), nobody who helps PCP (OR= 1,44 95% CI=4,61-0,54). 

CONCLUSIONS:  Socioeconomic factors affect the access to physical therapy, speech therapy or occupational therapy services in PCP . We suggest a public policy to improve the access to physical rehabilitation services of PCP in Bucaramanga and its metropolitan area.