Paulsen Rune Tendal, Bergholdt Erik, Carreon Leah, Rousing Rikke, Hansen Karen Højmark, Andersen Mikkel
Kirurgisk Sektion, Rygcenter Syddanmark, Sygehus Lillebælt, Middelfart, Østre Hougvej 55, 5500 Middelfart, Denmark.
Dan Med J. 2015 Jul;62(7).
Following the municipal reform in Denmark in January 2007, the municipalities gained responsibility for post-operative rehabilitation. In the Region of Southern Denmark, this task was decentralised to 22 municipalities, which implied a possible risk for considerable variation. This study examined rehabilitation in the 22 municipalities of the Region of Southern Denmark for patients with lumbar disk herniation.
A total of 22 physiotherapists answered a questionnaire regarding their rehabilitation programmes. The municipalities of 789 patients who had undergone decompressive surgery for lumbar disc herniation were identified. Changes in Oswestry disability index (ODI), EuroQol-5D (EQ-5D) and duration of sick leave were compared among the municipalities.
Patient-reported outcome measures showed no statistical difference in ODI, EQ-5D or sick leave at the one-year follow-up across the 22 municipalities. There was a correlation between sick leave and outcome as a longer sick leave was associated with less improvement in EQ-5D and ODI. Rehabilitation programmes across the region were comparable with respect to several factors. The questionnaire revealed a potential for enhanced cooperation between hospitals and rehabilitation centres.
Rehabilitation was broadly similar, and patient outcome after one year did not differ significantly across the 22 municipalities or between the five largest samples. In general, all municipalities request enhanced cooperation between hospital and rehabilitation unit to ensure the best possible patient treatment. Further studies should focus on the effect of rehabilitation.
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2007年1月丹麦进行市政改革后，各市负责术后康复工作。在南丹麦地区，这项任务被下放到22个市，这意味着存在显著差异的潜在风险。本研究调查了南丹麦地区22个市对腰椎间盘突出症患者的康复情况。
共有22名物理治疗师回答了一份关于他们康复计划的问卷。确定了789名接受过腰椎间盘突出症减压手术患者所在的市。比较了各市之间Oswestry功能障碍指数（ODI）、欧洲五维健康量表（EQ-5D）的变化以及病假时长。
患者报告的结局指标显示，在22个市中，一年随访时ODI、EQ-5D或病假方面无统计学差异。病假与结局之间存在相关性，因为病假时间越长，EQ-5D和ODI的改善程度越小。该地区的康复计划在几个因素方面具有可比性。问卷显示医院与康复中心之间有加强合作的潜力。
康复情况大致相似，22个市或五个最大样本之间患者一年后的结局无显著差异。总体而言，所有市都要求加强医院与康复单位之间的合作，以确保为患者提供尽可能最佳的治疗。进一步的研究应侧重于康复的效果。
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