Xu Gang, Xu Site, Gong Weiwei, Dong Shihong, Yu Hecheng
Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, 20072, People's Republic of China.
Department of Rehabilitation Medicine, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China.
J Multidiscip Healthc. 2023 May 16;16:1379-1392. doi: 10.2147/JMDH.S412398. eCollection 2023.
Herpes zoster (HZ) is a skin disease that can also cause virus-infectious peripheral neuropathies. Despite this, there is limited information on patient preferences for seeking medical attention for HZ and zoster-associated pain (ZAP). Our study aimed to evaluate how frequently patients with ZAP choose to visit neurologists for their symptoms.
This study conducted a retrospective review of electronic health records in three general hospitals from January 2017 to June 2022. Using association rule mining, the study analyzed referral behaviors.
We identified 33,633 patients with 111,488 outpatient visits over 5.5 years. The study found that the majority of patients (74.77-91.22%) visited dermatologists during their first outpatient visit, while only a small percentage (0.86-1.47%) preferred to consult a neurologist. The proportion of patients referred to a specialist during their medical visit varied significantly between different specialties within the same hospital (p <0.05) and even within the same specialty (p<0.05). There was a weak association (Lift:1.00-1.17) of referral behaviors between dermatology and neurology. Across the three hospitals, the average number of visits to a neurologist for ZAP was 1.42-2.49, with an average electronic health record duration of 11-15 days per patient. After consulting with a neurologist, some patients were referred to other specialists.
It was observed that patients with HZ and ZAP tended to visit a variety of specialists, with only a small number seeking the assistance of neurologists. However, from the perspective of neuroprotection, it is the duty of neurologists to provide more means.
带状疱疹(HZ)是一种皮肤病,也可引发病毒感染性周围神经病变。尽管如此,关于患者对HZ及带状疱疹相关性疼痛(ZAP)寻求医疗救治的偏好信息有限。我们的研究旨在评估ZAP患者因自身症状选择就诊于神经科医生的频率。
本研究对2017年1月至2022年6月期间三家综合医院的电子健康记录进行了回顾性分析。通过关联规则挖掘,分析了转诊行为。
我们在5.5年的时间里识别出33633例患者,共111488次门诊就诊。研究发现,大多数患者(74.77%-91.22%)在首次门诊就诊时看皮肤科医生,而只有一小部分(0.86%-1.47%)更倾向于咨询神经科医生。在同一家医院内,不同专科之间甚至同一专科内部,患者在就诊时被转诊至专科医生的比例差异显著(p<0.05)。皮肤科和神经科之间的转诊行为存在较弱的关联(提升度:1.00-1.17)。在这三家医院中,ZAP患者看神经科医生的平均就诊次数为1.42-2.49次,每位患者的电子健康记录平均时长为11-15天。在咨询神经科医生后,一些患者被转诊至其他专科医生。
观察发现,HZ和ZAP患者倾向于就诊于各类专科医生,只有少数患者寻求神经科医生的帮助。然而,从神经保护的角度来看,神经科医生有责任提供更多的方法。