目的:调查不同医学专业的转诊实践,并确定手外科转诊的可能障碍。一旦发生畸形,类风湿手畸形(RHD)和拇指腕掌(CMC)关节炎可能需要手术。然而,在沙特阿拉伯,转诊给手外科医师的比率仍然很低。
方法:这是一项横断面研究,包括102名家庭医学顾问,风湿病,和沙特阿拉伯各个地区的骨科。共联络了30家机构,并要求向其医师分发调查问卷;这些机构包括8家私家医院,16家政府医院,和6个初级保健中心。调查包括关于发病率的问题,rate,管理,知识,使用5点Likert量表对RHD和CMC关节炎患者进行转诊。在我们的分析中使用了Kruskal-WallisH检验来评估3个专业之间的反应差异。
结果:对于RHD和拇指CMC关节炎,与风湿病学家和家庭医学医师相比,骨科医师的转诊率较高.转诊的主要障碍是病人拒绝,单独的医疗被认为是足够的,以及缺乏对手术管理选择的认识。
结论:我们的发现强调了医生将RHD和拇指CMC关节炎病例转诊给手外科医师的模式上的差异,表明需要有针对性的干预措施来提高转诊率并提高患者预后.
OBJECTIVE: To investigate the referral practices across different medical specialties and identify possible barriers to hand surgery referral. Rheumatoid hand deformities (RHDs) and
thumb carpometacarpal (CMC) arthritis may require surgery once deformities occur. However, in Saudi Arabia, the rate of referrals to hand surgeons remains low.
METHODS: This was a cross-sectional study that included 102 consultants of family medicine, rheumatology, and orthopedics across various regions of Saudi Arabia. A total of 30 institutions were contacted and requested to distribute a survey questionnaire to their physicians; these institutions included 8 private hospitals, 16 government hospitals, and 6 primary healthcare centers. The survey included questions on the incidence, rate, management, knowledge, and referral of patients with RHD and CMC arthritis using a 5-point Likert scale. The Kruskal-Wallis H test was utilized in our analysis to evaluate the differences in responses among the 3 specialties.
RESULTS: For RHD and
thumb CMC arthritis, the referral rate was higher among orthopedic surgeons compared to rheumatologists and family medicine physicians. The main barriers to referral were patient refusal, medical treatment alone being deemed adequate, and a lack of awareness of surgical options for management.
CONCLUSIONS: Our findings highlight discrepancies in patterns of physician referral of RHD and
thumb CMC arthritis cases to hand surgeons, indicating the need for targeted interventions to improve referral rates and enhance patient outcomes.