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功能性腹痛患者二级医疗保健利用情况的定量评估

Quantitative Assessment of Secondary Healthcare Utilisation by Patients With Functional Abdominal Pain.

作者信息

MacVicar Emma, Insch Pauline, Summers Fiona, Bruce Duff, Ramsay George

机构信息

Medicine and Surgery, University of Aberdeen School of Medicine, Aberdeen, GBR.

Clinical Psychology, NHS Grampian, Aberdeen, GBR.

出版信息

Cureus. 2022 May 19;14(5):e25145. doi: 10.7759/cureus.25145. eCollection 2022 May.

Abstract

There is increasing awareness of the impact functional conditions have on the National Health Service (NHS). Less is known about the resources used to manage these conditions. This retrospective quantitative audit aims to determine the demographic and healthcare utilisation of functional abdominal pain patients presenting to the hospital. The most frequent hospital attenders with non-specific abdominal pain in NHS Grampian, 2018-2019, were assessed (n=144). Adult patients meeting the ROME II diagnostic criteria for functional abdominal pain diagnosis were included (n=33). Data were retrospectively collected manually from electronic medical records. Of 33 patients, 93.9% were female, with a mean age of 31.2 years. Each had accessed a mean of 11.5 specialist services, with 69.7% being referred to mental health services; 9.1% had completed treatment. Each patient had a median 4 (range 1-26) emergency/unscheduled presentations to hospital and median 2 (range 0-13) admissions for functional abdominal pain during the study period, with a total of 247 nights spent in hospital by this patient cohort for functional abdominal pain alone. The estimated total cost for these hospital admissions was £593,786.00. Extensive secondary-care input is currently required for patients with functional abdominal pain at a significant cost. Patients are re-presenting to the hospital frequently, which suggests that current management is not effective.

摘要

人们越来越意识到功能失调性疾病对国民医疗服务体系(NHS)的影响。但对于管理这些疾病所使用的资源却知之甚少。这项回顾性定量审计旨在确定到医院就诊的功能性腹痛患者的人口统计学特征和医疗服务利用情况。对2018 - 2019年NHS格兰扁地区非特异性腹痛最常就诊的患者进行了评估(n = 144)。纳入了符合功能性腹痛诊断的罗马II诊断标准的成年患者(n = 33)。数据通过人工方式从电子病历中回顾性收集。33例患者中,93.9%为女性,平均年龄31.2岁。每位患者平均使用了11.5种专科服务,69.7%被转诊至精神卫生服务机构;9.1%完成了治疗。在研究期间,每位患者因功能性腹痛到医院急诊/非预约就诊的中位数为4次(范围1 - 26次),住院的中位数为2次(范围0 - 13次),该患者队列仅因功能性腹痛就总共在医院住了247个夜晚。这些住院的估计总费用为593,786.00英镑。目前,功能性腹痛患者需要大量的二级医疗投入,成本高昂。患者频繁再次到医院就诊,这表明目前的管理措施无效。

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