Giles Lynton G F, Muller Reinhold, Winter Gregory J
School of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia.
J Manipulative Physiol Ther. 2003 Jun;26(5):293-9. doi: 10.1016/S0161-4754(03)00045-9.
To prospectively document the satisfaction of a random sample of patients attending a specialized multidisciplinary spinal pain unit in the Australian public health care system and to collect associated data on patient characteristics, radiological findings, treatment modalities used, and any significant complications. Design and setting Spinal pain syndrome patients attended the specialized Multidisciplinary Spinal Pain Unit at Townsville General Hospital and the Kirwan Community Health Centre (Queensland, Australia) for diagnosis and management (ie, chiropractic spinal manipulation, medication, or needle acupuncture). A patient satisfaction questionnaire was sent to a random sample of patients in this Queensland Government funded service that was approved by the health authority's Ethics Committee.
A total of 1775 new patients (949 men, 826 women; aged 10 to 91 years; average age = 43 years) visited the unit. Medical referral accounted for 40% of patients, chiropractic for 2%, osteopathy for 1%, and other referrals for 0.7%; 40.3% were self-referred and 16% were specifically referred for a medicolegal consultation and examination following work-related or motor vehicle accident injuries. Thirty-nine patients (2.2%) were found to have acute pain (< 28 days). Of 941 patients who could accurately recall when symptoms first began, 69 (7.3%) presented with subacute pain (4 to 12 weeks duration), and 872 (92.7%) presented with chronic spinal pain syndrome (>12 weeks duration). Following extensive investigations, 1474 patients (83%) had radiologically identifiable abnormalities, including osseous or soft tissue anomalies. There was only 1 significant complication (pneumothorax) out of 7831 acupuncture treatment sessions, representing 0.01% of patients and 0.006% of a total of 16,936 examinations and treatments administered at the unit. The patient satisfaction questionnaire resulted in an extremely high satisfaction score.
A public hospital or community health center based specialized spinal pain syndrome unit is useful for referring clinicians who wish to obtain a further opinion for challenging spinal pain syndrome patients in the lower socioeconomic group that cannot afford private health care.
前瞻性记录澳大利亚公共医疗系统中一家专门的多学科脊柱疼痛科随机抽取的患者样本的满意度,并收集有关患者特征、放射学检查结果、所采用的治疗方式以及任何重大并发症的相关数据。设计与机构 脊柱疼痛综合征患者前往汤斯维尔综合医院和基尔万社区健康中心(澳大利亚昆士兰州)的专门多学科脊柱疼痛科进行诊断和治疗(即脊椎按摩疗法、药物治疗或针刺疗法)。向该由昆士兰州政府资助且经卫生当局伦理委员会批准的服务中的随机抽取的患者样本发放了患者满意度调查问卷。
共有1775名新患者(949名男性,826名女性;年龄10至91岁;平均年龄 = 43岁)就诊于该科室。医疗转诊患者占40%,脊椎按摩疗法转诊患者占2%,整骨疗法转诊患者占1%,其他转诊患者占0.7%;40.3%为自我转诊患者,16%是因工作相关或机动车事故受伤后专门转诊进行法医学咨询和检查的患者。发现39名患者(2.2%)患有急性疼痛(<28天)。在941名能够准确回忆症状首次出现时间的患者中,69名(7.3%)表现为亚急性疼痛(持续4至12周),872名(92.7%)表现为慢性脊柱疼痛综合征(持续>12周)。经过广泛检查,1474名患者(83%)有放射学可识别的异常,包括骨骼或软组织异常。在7831次针刺治疗疗程中仅出现1例重大并发症(气胸),占患者的0.01%,占该科室总共16936次检查和治疗的0.006%。患者满意度调查问卷得出了极高的满意度评分。
对于希望为无力承担私立医疗保健的社会经济地位较低群体中具有挑战性的脊柱疼痛综合征患者获取进一步意见的转诊临床医生而言,基于公立医院或社区健康中心的专门脊柱疼痛综合征科室很有用。