Bekkelund S I, Salvesen R
Department of Neurology, Tromsø University Hospital, Norway.
Fam Pract. 2001 Oct;18(5):524-7. doi: 10.1093/fampra/18.5.524.
Headache is a common problem in primary care. Although most patients are treated by GPs, many are referred to specialist consultation. Knowledge of how the referrals can be improved is therefore an important issue.
The aim of this study was to determine the relationship between self-initiating referral to a neurologist and the patient's satisfaction with the specialist consultation.
All patients who had been examined by a neurologist for headache within a 2-year period from three neurological centres in North Norway completed a questionnaire.
A total of 1052 patients from a population of 1403 headache patients (75%) returned the questionnaire while 927 patients answered questions about initiating the referral to the specialist. Two hundred and twenty patients (24%) initiated the referral to the neurologist themselves; 52% of those who self-initiated the referral were dissatisfied with the specialist consultation compared with 42% of those referred by the doctor, P = 0.002. Chronic headache, tension-type headache (TTH) and daily use of analgesic drugs were associated with dissatisfaction.
Patients with headache who initiated the referral to a neurologist themselves were less satisfied with the specialist consultation. Selecting referrals containing proper medical information may improve satisfaction in severe headache patients treated in a neurological practice.
头痛是基层医疗中的常见问题。尽管大多数患者由全科医生治疗,但许多患者会被转诊至专科医生处进行会诊。因此,了解如何改善转诊是一个重要问题。
本研究旨在确定自行转诊至神经科医生与患者对专科会诊的满意度之间的关系。
来自挪威北部三个神经科中心的所有在两年内因头痛接受神经科医生检查的患者均完成了一份问卷。
在1403名头痛患者中,共有1052名患者(75%)返回了问卷,而927名患者回答了关于启动转诊至专科医生的问题。220名患者(24%)自行转诊至神经科医生;自行转诊的患者中有52%对专科会诊不满意,而医生转诊的患者中这一比例为42%,P = 0.002。慢性头痛、紧张型头痛(TTH)和每日使用镇痛药与不满意有关。
自行转诊至神经科医生的头痛患者对专科会诊的满意度较低。选择包含适当医疗信息的转诊可能会提高在神经科诊所接受治疗的重度头痛患者的满意度。