Casabella B, Aguilar M
Unidad Docente de Medicina Familiar y Comunitaria de Barcelona, CAP Cornellà.
Aten Primaria. 1990 Sep;7(8):538-44.
The aim of this study was to evaluate the proportion of neurological disorders within the overall number of ailments treated in primary care, as well as to classify them, determine the reason for their referral to specialists, and analyze the appropriateness or justification of such referral in each case. The 553 neurological visits analyzed represented 6.1% of the total (non-bureaucratic-related) number of requests for medical care. The groups cephalea/facial pain, dizziness and partial or complex seizures accounted for 60% of total. One of every three visits was referred to a neuropsychiatrist and/or hospital service. The main cause for the referral was considered clinical in only 28.3% of cases. The referral was judged inappropriate by the specialist in 13.4% of cases. The evidence that neurological disorders are not unusual, in addition to the high rate of referrals and an analysis of the reason and justification for referral, reflect the need to focus on the neurological training of non-neurologists, as well as to evaluate the appropriateness of present specialized outpatient care.
本研究的目的是评估基层医疗中所治疗的疾病总数里神经疾病的占比，对其进行分类，确定将患者转诊至专科医生的原因，并分析每种情况下这种转诊的合理性或正当性。所分析的553例神经科就诊病例占医疗护理请求总数（与官僚程序无关）的6.1%。头痛/面部疼痛、头晕以及部分或复杂性癫痫发作这几类疾病占总数的60%。每三次就诊中就有一次被转诊至神经精神科医生和/或医院服务部门。转诊的主要原因在仅28.3%的病例中被认为是临床因素。专科医生判定13.4%的转诊病例不恰当。神经疾病并不罕见的证据，加上转诊率高以及对转诊原因和正当性的分析，反映出有必要关注非神经科医生的神经学培训，以及评估当前专科门诊护理的适宜性。
