Bennett Karina, de Boisanger Louis, Moreton Fiona, Davenport Richard, Stone Jon
Department of Clinical Neurosciences, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK,
Department of Clinical Neurosciences, NHS Lothian, Western General Hospital, Edinburgh, UK.
J R Coll Physicians Edinb. 2019 Sep;49(3):193-198. doi: 10.4997/JRCPE.2019.305.
Neurology referrals from primary care are increasing. Actively triaging referrals is one way of providing a better patient-focussed service.
We reviewed the safety and cost-effectiveness of 'advice only' rather than face-to-face appointments for neurology patients via active triage. Referrals triaged as 'advice only' were identified over a 6-month period. Data were collected on reason for referral, opinion of triaging neurologist and whether the patient re-presented to neurology within 12 months.
A total of 10% (236 out of 2,445) of referred patients were given advice only after active triage. A total of 71% (n = 167) had no further secondary care presentations in 12 months. The most common presentation was headache (n = 57; 13%). One patient had a major diagnostic change following delayed review.
'Advice only' allows patients to receive timely advice and management. It appears safe and is likely to be cost effective, although further data are required on whether it provides satisfactory outcomes for patients and general practitioners.
基层医疗转诊至神经科的患者数量在增加。积极对转诊进行分流是提供更以患者为中心服务的一种方式。
我们回顾了通过积极分流为神经科患者提供“仅建议”而非面对面预约的安全性和成本效益。在6个月的时间里确定了被分流为“仅建议”的转诊患者。收集了转诊原因、分流神经科医生的意见以及患者在12个月内是否再次到神经科就诊的数据。
在积极分流后，共有10%（2445例中的236例）转诊患者仅得到了建议。共有71%（n = 167）的患者在12个月内没有再次接受二级医疗服务。最常见的症状是头痛（n = 57；13%）。1例患者在延迟复查后诊断有重大变化。
“仅建议”使患者能够及时获得建议和管理。它似乎是安全的，并且可能具有成本效益，不过还需要进一步的数据来确定它是否能为患者和全科医生带来满意的结果。
