Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Co. Offaly, Tullamore, R35 NY51, Ireland.
Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
Ir J Med Sci. 2019 Aug;188(3):735-741. doi: 10.1007/s11845-018-1911-1. Epub 2018 Oct 18.
Disorders of the musculoskeletal system are the main cause of disability and lost working days worldwide, and osteoarthritis affects almost half a million people in Ireland. Appropriate access and resourcing of general practice and orthopaedics is a necessary measure for the provision of a safe and efficient health service. One area that remains particularly challenging in Ireland is that of outpatient waiting lists, and the purpose of this study was to assess the attitudes and experiences of general practitioners in the Irish midlands with regard to orthopaedic services and to evaluate these in the context of national strategies and international best practice.
A survey was sent to general practitioners in the midlands looking at five main areas: elective services, trauma services, allied health services, patient access and practice demographics.
98.7% of general practitioners surveyed stated they either agree or strongly agree that there is a significant difference in terms of access between public and private services. The average waiting time for an elective orthopaedic outpatient clinic is more than 1 year as per 92.3% of GPs surveyed with 89.7% of GPs stating that the average waiting time for an elective private outpatient appointment being between 0 and 3 months. Over three quarters of GPs surveyed either disagree or strongly disagree that there is adequate access to physiotherapy and occupational therapy services in the community with nearly 80% and 93.6% stating they have no physiotherapist or occupational therapist respectively attached to their practice.
MSK disorders are a significant burden on the Irish health service and inadequate investment in general practice, allied health practitioner-led facilities and orthopaedic services remains a serious challenge that requires considerable attention to insure adequate patient care, safety and best practice.
肌肉骨骼系统疾病是全球残疾和丧失工作日的主要原因,骨关节炎影响了爱尔兰近 50 万人。适当的获得和配置普通科和矫形科资源是提供安全有效的卫生服务的必要措施。爱尔兰在门诊病人等候名单方面仍然面临着特别具有挑战性的问题,本研究的目的是评估爱尔兰中部地区的全科医生对矫形服务的态度和经验,并根据国家战略和国际最佳做法评估这些服务。
向爱尔兰中部地区的全科医生发送了一份调查,调查涉及五个主要领域:择期服务、创伤服务、联合保健服务、患者获得途径和实践人口统计学。
接受调查的全科医生中,98.7%表示他们同意或强烈同意公共服务和私人服务在获得途径方面存在显著差异。根据 92.3%的全科医生的调查,择期矫形门诊的平均等候时间超过 1 年,89.7%的全科医生表示,择期私人门诊的平均等候时间在 0 至 3 个月之间。超过四分之三的接受调查的全科医生表示,他们不同意或强烈不同意在社区中获得足够的物理治疗和职业治疗服务,近 80%和 93.6%的医生分别表示他们没有物理治疗师或职业治疗师在他们的诊所工作。
肌肉骨骼疾病对爱尔兰卫生服务造成了重大负担,对普通科、联合保健医生主导的设施和矫形科服务的投资不足仍然是一个严重的挑战,需要相当大的关注,以确保患者得到充分的护理、安全和最佳实践。