Davies H T, Crombie I K, Macrae W A
Department of Epidemiology and Public Health, University of Dundee.
Anaesthesia. 1994 Aug;49(8):661-5. doi: 10.1111/j.1365-2044.1994.tb04392.x.
Patients with chronic pain may benefit from referral to a pain specialist. This study describes the delay between referral and first appointment of 3386 new referrals seen in ten outpatient pain clinics between 1990 and 1992. We then assess the follow-up patterns of the pain clinics and how these relate to waiting times. Patients wait in pain for long periods before being seen in a pain clinic. In 1992 about half of patients waited more than 3 months for an appointment at a teaching hospital pain clinic; and half waited 9 weeks or longer to be seen at a district general hospital pain clinic. In many clinics the situation is worsening. Pain clinics differ widely in their patient follow-up, with patients averaging more than twice as many visits in some clinics than others. Clinic practice on reappointing patients largely determines the number of new referrals who can be accepted for management, and hence affects waiting lists. Thus our data suggest that pain clinics themselves can help reduce waiting times, by changing the extent and nature of patient follow-up. Ultimately, however, additional consultant sessions may be needed to enable pain clinics to meet the increasing demands placed on them.
慢性疼痛患者转诊至疼痛专科医生处可能会受益。本研究描述了1990年至1992年间在十家门诊疼痛诊所就诊的3386名新转诊患者从转诊到首次预约之间的延迟情况。然后我们评估了疼痛诊所的随访模式以及这些模式与等待时间的关系。患者在疼痛中等待很长时间才得以在疼痛诊所就诊。1992年，约一半的患者在教学医院疼痛诊所等待预约超过3个月；另一半患者在地区综合医院疼痛诊所等待就诊9周或更长时间。在许多诊所，情况正在恶化。疼痛诊所的患者随访差异很大，有些诊所的患者平均就诊次数是其他诊所的两倍多。诊所重新安排患者就诊的做法在很大程度上决定了能够接受管理的新转诊患者数量，从而影响候诊名单。因此，我们的数据表明，疼痛诊所本身可以通过改变患者随访的程度和性质来帮助减少等待时间。然而，最终可能需要增加会诊时段，以使疼痛诊所能够满足对其日益增长的需求。
