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基层医生将患者转介给物理治疗师的可能性对于某些健康问题较低:对改善健康评估和护理(BEACH)观察性研究的二次分析。

The likelihood of general practitioners referring patients to physiotherapists is low for some health problems: secondary analysis of the Bettering the Evaluation and Care of Health (BEACH) observational study.

机构信息

Discipline of Physiotherapy, University of Sydney, Sydney.

Australian Physiotherapy Association, Melbourne.

出版信息

J Physiother. 2018 Jul;64(3):178-182. doi: 10.1016/j.jphys.2018.05.006. Epub 2018 Jun 11.

Abstract

QUESTIONS

Which health problems do medical general practitioners (GPs) most commonly refer to physiotherapists? What is the likelihood of GPs referring patients for specific health problems?

DESIGN

Secondary analysis of data from the Bettering the Evaluation and Care of Health (BEACH) study, which is a national observational study of Australian general practice clinical activity.

PARTICIPANTS

People at GP encounters between April 2010 and March 2015.

OUTCOME MEASURES

The outcomes were the proportion of all (new) health problems that were referred to a physiotherapist, the distribution of health problems referred to physiotherapists, and the likelihood of referral of (all and new) specific health problems to physiotherapists.

RESULTS

There were 6904 referrals to a physiotherapist from 775893 GP encounters, which equated to 0.89% (95% CI 0.86 to 0.92). Among the 286858 new health problems, 2987 were referred to a physiotherapist (1.04%, 95% CI 0.99 to 1.09). The health problems that were most commonly referred were back complaints (18.6%), sprains (10.3%) and osteoarthritis (8.6%). However, when these three problems presented as a new health problem, the likelihood of referral was low (14.4, 11.9 and 5.4%, respectively). The new health problems most likely to result in a referral were acquired deformity of the spine (which includes kyphoscoliosis, kyphosis, lordosis and scoliosis) (17.7%, 95% CI 8.2 to 27.2) and neck complaints (17.4%, 95% CI 14.3 to 20.6).

CONCLUSIONS

Most referrals made to physiotherapists were for musculoskeletal problems. However, even among the most commonly referred problems (such as back complaints and osteoarthritis), the likelihood of referral was low when they presented as a new problem. There is an opportunity to increase referrals from general practice to physiotherapy for many common conditions with effective physiotherapy interventions. [Dennis S, Watts I, Pan Y, Britt H (2018) The likelihood of general practitioners referring patients to physiotherapists is low for some health problems: secondary analysis of the Bettering the Evaluation and Care of Health (BEACH) observational study. Journal of Physiotherapy 64: 177-181].

摘要

问题

全科医生(GP)最常向物理治疗师转诊哪些健康问题?GP 为特定健康问题转诊患者的可能性有多大?

设计

对 Bettering the Evaluation and Care of Health(BEACH)研究数据的二次分析,该研究是对澳大利亚全科实践临床活动的全国性观察性研究。

参与者

2010 年 4 月至 2015 年 3 月间在全科医生就诊的患者。

结局测量

结局为所有(新)健康问题中被转诊至物理治疗师的比例、被转诊至物理治疗师的健康问题分布,以及(所有和新)特定健康问题转诊至物理治疗师的可能性。

结果

在 775893 次全科医生就诊中,有 6904 次转诊至物理治疗师,占 0.89%(95%CI 0.86 至 0.92)。在 286858 个新出现的健康问题中,有 2987 个被转诊至物理治疗师(1.04%,95%CI 0.99 至 1.09)。最常被转诊的健康问题是背部投诉(18.6%)、扭伤(10.3%)和骨关节炎(8.6%)。然而,当这些三个问题作为新出现的健康问题出现时,转诊的可能性较低(分别为 14.4%、11.9%和 5.4%)。最有可能导致转诊的新健康问题是获得性脊柱畸形(包括脊柱后凸、脊柱前凸、脊柱侧凸和脊柱侧凸)(17.7%,95%CI 8.2 至 27.2)和颈部投诉(17.4%,95%CI 14.3 至 20.6)。

结论

大多数转介给物理治疗师的是肌肉骨骼问题。然而,即使是在最常被转介的问题(如背部投诉和骨关节炎)中,当它们作为新问题出现时,转介的可能性也很低。对于许多常见疾病,通过有效的物理治疗干预,有机会增加从全科医疗向物理治疗的转介。

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