Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
J Rehabil Med. 2024 Aug 20;56:jrm39912. doi: 10.2340/jrm.v56.39912.
To examine patients' use of primary healthcare (PHC) before and after specialized rehabilitation and its relation with self-reported health and functioning.
Longitudinal cohort study.
451 rehabilitation patients.
Register data were used to measure the frequency of visits to the general practitioner (GP) and physiotherapist (PT) in PHC 3 years before and after rehabilitation. Patients reported health (EQ-VAS) and functioning (SF-36) before rehabilitation and at 1 and 3 years after. Data are described for the total study cohort and subgroups with musculoskeletal disease (MSD) and cardiovascular disease (CVD).
There was an increase in GP and PT visits preceding rehabilitation and a gradual decrease thereafter. An exception was GP visits among patients with CVD, with few diagnosis-specific visits before but an increase after. Lower levels of health and functioning tended to be related to more frequent GP and PT visits. An indication of clinically important improvement was found among those with frequent GP visits in the MSD subgroup, and among those with 1-2 GP visits in the CVD subgroup.
The diverse relationship between health and functioning, and the use of PHC services at follow-up, may imply that additional factors besides healthcare use explain long-term improvement following rehabilitation.
考察患者在接受专科康复治疗前后对初级卫生保健（PHC）的使用情况及其与自我报告的健康和功能的关系。
纵向队列研究。
451 名康复患者。
使用登记数据来衡量康复前 3 年和康复后患者在 PHC 中看全科医生（GP）和物理治疗师（PT）的就诊频率。患者在康复前以及康复后 1 年和 3 年报告健康状况（EQ-VAS）和功能（SF-36）。数据按总研究队列以及肌肉骨骼疾病（MSD）和心血管疾病（CVD）亚组进行描述。
在康复前，GP 和 PT 的就诊次数增加，此后逐渐减少。CVD 患者的 GP 就诊次数是个例外，他们在康复前的诊断特异性就诊次数较少，但康复后的就诊次数增加。健康和功能水平较低往往与 GP 和 PT 就诊次数较多有关。在 MSD 亚组中，频繁看 GP 的患者中出现了临床意义上的显著改善，而在 CVD 亚组中，看 1-2 次 GP 的患者中也出现了这种情况。
健康和功能与 PHC 服务使用之间的这种多样化关系可能意味着，除了医疗保健的使用之外，还有其他因素可以解释康复后长期的改善。
