López-Hernández N, Espinosa-Martínez J
Sección de Neurología, Hospital General Universitario de Elche, 03203 Elche, España.
Rev Neurol. 2007;45(4):219-23.
To conduct a descriptive study of the welfare work carried out during one year in visits to ambulatory outpatient neurology clinics in the health district of Elche.
We carried out a prospective study of data from the first visits to two outpatient neurology clinics between 1st May 2005 and 30th April 2006.
A total of 3229 first-time visits were attended, with a mean age of 56.8 years (SD: 21) and 62% were females. The incidence of first-time visits was 18.9 per 1000 inhabitants over the age of 14 years per year. In all, 18% missed their appointments. Results showed that 93.9% of the visits came from Primary Care, with a total mean delay of 30.6 days (16.1 days in the preferential cases and 35.8 in ordinary cases). The most frequent reasons for referral were: headaches (27.2%), cognitive disorders (15.9%), applications for visas or orthopaedic material (8.3%), impaired levels of consciousness/paroxysms with suspected epilepsy (7.3%), dizziness/instability/vertigo (6.8%) and tremor (5.9%). The most frequent diagnoses were headache (28% of the total number; 41.35% of the group less than 65 years old), cognitive impairment (12.24% of the total number; 28.9% of the group equal or more than 65 years old), cerebrovascular disease (8.7%) and epilepsy (5.1%). Patients with a non-neurological pathology accounted for 21.8% of the total number.
In our environment, headache continues to be the leading reason behind referrals to the neurologist. One notable point is the high frequency with which patients without any kind of neurological disorder are referred; the same can be said for those referred for bureaucratic reasons (visas and prescriptions for orthopaedic materials).
对在埃尔切健康区的门诊神经科诊所进行的为期一年的福利工作进行描述性研究。
我们对2005年5月1日至2006年4月30日期间首次到两家门诊神经科诊所就诊的数据进行了前瞻性研究。
共接待了3229例首次就诊患者,平均年龄为56.8岁(标准差:21),62%为女性。14岁以上居民每年首次就诊的发病率为每1000人中有18.9例。总共有18%的患者未赴约。结果显示,93.9%的就诊患者来自初级保健机构,总平均延迟时间为30.6天(优先病例为16.1天,普通病例为35.8天)。转诊最常见的原因是:头痛(27.2%)、认知障碍(15.9%)、签证申请或骨科材料申请(8.3%)、意识水平受损/疑似癫痫的发作(7.3%)、头晕/不稳定/眩晕(6.8%)和震颤(5.9%)。最常见的诊断是头痛(占总数的28%;65岁以下组的41.35%)、认知障碍(占总数的12.24%;65岁及以上组的28.9%)、脑血管疾病(8.7%)和癫痫(5.1%)。患有非神经科疾病的患者占总数的21.8%。
在我们的环境中,头痛仍然是转诊至神经科医生的主要原因。一个值得注意的点是,没有任何神经疾病的患者被转诊频率很高;因官僚原因(签证和骨科材料处方)被转诊的患者也是如此