Marks Darryn, Pearce-Higgins Jasmine, Frost Taylor, Fittock Joseph, Rathbone Evelyne, Hing Wayne
Bond University, Robina, QLD, Australia.
Gold Coast University Hospital, Southport, QLD, Australia.
Health Serv Insights. 2024 Dec 3;17:11786329241304615. doi: 10.1177/11786329241304615. eCollection 2024.
Efficient musculoskeletal care is important for health services and society. Surgical conversion rates are a common measure of efficiency, yet normal values and the impact of referrer type are unclear. This information could assist musculoskeletal care, service benchmarking and redesign.
A systematic review with meta-analysis was undertaken with PubMed, CINAHL and EMBASE databases searched from inception to 12th of October 2024, to identify studies from which musculoskeletal surgical conversion rates could be extracted. Data were categorised according to the professional group responsible for referral (all doctors, general practitioners, sports physicians, allied-health/physiotherapy-led screening services) and methodology used to define surgical conversion. Meta-analysis of pooled data was undertaken.
Twenty-eight studies with a combined total of 5358 patients were included. Pooled data revealed surgical conversion rates of 23% for referrals from all types of doctors (0.23, 95% CI 0.18-0.27), 28% from general practitioners (0.28, 95% CI 0.12-0.52), 61% from allied health physiotherapy-led screening services (0.61, CI 0.50-0.70) and 70% from sports physicians at (0.70, CI 0.64-0.75). A variety of methodological factors impacted surgical conversion rate reporting and heterogeneity.
Musculoskeletal services seeking to improve efficiency through higher surgical conversion rates, should include sports physician and/or physiotherapy-led models of care for referral generation or management.
高效的肌肉骨骼护理对卫生服务和社会至关重要。手术转化率是衡量效率的常用指标，但正常值以及转诊医生类型的影响尚不清楚。这些信息有助于肌肉骨骼护理、服务基准设定和重新设计。
进行了一项系统综述并荟萃分析，检索了PubMed、CINAHL和EMBASE数据库，检索时间从建库至2024年10月12日，以识别可提取肌肉骨骼手术转化率的研究。数据根据负责转诊的专业组（所有医生、全科医生、运动医学医生、联合健康/物理治疗主导的筛查服务）以及用于定义手术转换的方法进行分类。对汇总数据进行荟萃分析。
纳入了28项研究，共计5358名患者。汇总数据显示，各类医生转诊的手术转化率为23%（0.23，95%可信区间0.18 - 0.27），全科医生转诊的为28%（0.28，95%可信区间0.12 - 0.52），联合健康物理治疗主导的筛查服务转诊的为61%（0.61，可信区间0.50 - 0.70），运动医学医生转诊的为70%（0.70，可信区间0.64 - 0.75）。多种方法学因素影响手术转化率的报告和异质性。
寻求通过提高手术转化率来提高效率的肌肉骨骼服务，应纳入运动医学医生和/或物理治疗主导的护理模式以进行转诊生成或管理。
