Redcliffe Hospital, Redcliffe, Queensland, Australia.
Mater Hospital, Brisbane, Queensland, Australia.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720967228. doi: 10.1177/2150132720967228.
A "virtual fracture clinic" (VFC) is viewed as a safe, cost effective method of managing suitable low risk orthopedic injuries without direct orthopedic review. This method is used throughout the Glasgow Royal Infirmary (GRI) and National Health System (NHS) as a cornerstone for efficient patient care. This study assessed the outcomes of a newly implemented Queensland based Primary Care Pathway (PCP) for management of simple orthopedic injuries.
A prospective cohort was formed of patients presenting over a 4-week period with an acute orthopedic injury to either the Emergency Department (ED) or Primary Care Providers within the Logan Hospital catchment in Queensland, Australia. Patients were triaged to either a PCP management protocol with General Practitioners (GP), Allied-Health Professionals (AHP) or to a traditional in-person Fracture Clinic (FC) orthopedic review. Patients were followed for 6-months. Data were collected about epidemiology, complications, appropriate allocation, and injury type.
A total of 1283 patients were referred over the study period, of which 267 were triaged to PCP management. ED referrals accounted for 62.5% of appropriate referrals to either clinic. Upper limb injuries were the most common conditions managed through the PCP. Patients managed by the PCP model of care experienced a 4.29% complication rate over the 6-month follow-up period.
The PCP model of care is effective in managing criteria specific, low risk orthopedic injuries with a low rate of complications (4.29%) without direct orthopedic FC review. Use of a PCP reduces demand on hospital resources, and provides a safe, cost-effective alternative to a resource-restricted outpatient service.
“虚拟骨折门诊”（VFC）被视为一种安全且具有成本效益的方法，可在无需直接骨科评估的情况下管理合适的低风险骨科损伤。这种方法在格拉斯哥皇家医院（GRI）和国民保健制度（NHS）中被广泛应用，是高效患者护理的基石。本研究评估了昆士兰州新实施的初级保健途径（PCP）在管理简单骨科损伤方面的结果。
在澳大利亚昆士兰州洛根医院收治范围内，对在 4 周内因急性骨科损伤到急诊科（ED）或初级保健提供者就诊的患者进行前瞻性队列研究。患者分诊至由全科医生（GP）、联合保健专业人员（AHP）管理的 PCP 管理方案，或传统的门诊骨折门诊（FC）骨科评估。对患者进行 6 个月的随访。收集有关流行病学、并发症、适当分配和损伤类型的数据。
在研究期间共转介了 1283 例患者，其中 267 例分诊至 PCP 管理。ED 转介占这两个诊所适当转介的 62.5%。上肢损伤是通过 PCP 管理的最常见疾病。通过 PCP 管理模式治疗的患者在 6 个月的随访期间并发症发生率为 4.29%。
PCP 管理模式可有效管理特定标准、低风险的骨科损伤，并发症发生率低（4.29%），无需直接进行骨科 FC 评估。使用 PCP 可减少对医院资源的需求，并为资源有限的门诊服务提供安全、具有成本效益的替代方案。
