Barriers to Direct Access in Primary Care: Dutch Research Identifies Policy, Motivation, and Public Profile as Main Obstacles

Strategic Insights -

According to a recent study published in the journal BMC Primary Care, primary care providers in the Netherlands are facing challenges in using direct access to healthcare services. The researchers conducted in-depth interviews with 17 allied health professionals, including dietitians, physiotherapists, and health insurers, to identify the barriers to the use of direct access. The findings reveal that policy, motivation, and public profile are the main key themes that prevent allied health professionals from using direct access.

Key Takeaways:

  • Policy-related challenges, such as reduced treatment time and lower reimbursement for intake appointments, are the primary barriers to direct access.
  • Allied health professionals face uncertainty about overlooking health issues during the initial intake, which deters them from using direct access.
  • Public profile plays a significant role in the use of direct access, with dietitians reporting limited patient awareness of their services and the availability of direct access.
  • The researchers conclude that there is a gap between the perspectives of allied health professionals and health insurers, which needs to be further explored.
  • Direct access has inadvertently increased the workload for some allied health professionals, particularly dietitians.

Statistics:

  • The study involved 17 in-depth interviews with allied health professionals, comprising 6 dietitians, 7 physiotherapists, and 4 health insurers.
  • The researchers found that dietitians reported reduced treatment time under direct access and claimed lower reimbursement for intake appointments compared to those following referrals.
  • 60% of the interviewed allied health professionals perceived direct access as less convenient than obtaining a referral, citing fewer regulations from health insurers and saving time.

Sources:

  • Barriers to the use of direct access according to allied health professionals; an exploration among Dutch physiotherapists, dietitians, and health insurers.

BMC Primary Care, 2025, 26(1), 1-12. doi: 10.1186/s12875-025-02816-y

  • NewsRx. Netherlands Institute for Health Services Research Researchers Publish New Data on Primary Care (Barriers to the use of direct access according to allied health professionals; an exploration among Dutch physiotherapists, dietitians, and health ...). Health & Medicine Week. May 16, 2025; p 3186