Perceived Barriers to PT Care for Musculoskeletal Injury in Active-Duty Service Members at a Navy Shore-Based Medical Clinic.

INTRODUCTION: Musculoskeletal injuries (MSI) are common and affect readiness in Navy active-duty service members (ADSM). Patients receive high quality medical care through their Navy Medical Center but may not always access the care they need. Understanding perceived barriers to care for MSI could guide modifications to policy and delivery of health care to better support operational readiness. MATERIALS AND METHODS: All ADSM presenting to a Navy medical clinic for MSI between December 2021 and August 2023 were included in recruitment efforts. As part of a larger study, participants completed a series of baseline questionnaires following initial PT evaluation. This paper reports on responses to an open-ended query regarding perceived barriers to care. Responses were reviewed by three of the investigators and categories and subcategories of barriers were created by consensus. RESULTS: Two hundred fifty-six participants responded to the study question. Fifty one percent listed at least one barrier to treatment, 43% replied "none" or "NA" and 5.8% left the response field blank. Of the 51% who answered affirmatively, 9 (6.5%) listed two barriers. Responses comprised five categories and eight subcategories of barriers. They were Working Conditions 35%, with subcategories: work schedule conflicts, staffing deficits in unit, strenuous work demands, travel to treatment time, Unit Attitudes 25%, with subcategories: lack of supervisor/CoC support, lack of coworkers support, Health Care Conditions 27%, with subcategories: lack of available appointments, concerns about appropriate care, Policies and Procedures of the DoD 5%, and Personal Issues 1.4%. CONCLUSIONS: Over half of participants surveyed reported an obstacle to receiving care perceived necessary to resolve their MSI. Main concerns were factors related to work duties, attitudes of superiors or coworkers and the health care delivery system. Understanding patient-perceived obstacles to care can shed light on ways to improve patient outcomes.