A descriptive analysis of ambulatory neurological care demand in Burgos Health Area

To determine the ambulatory neurological care demand in Burgos Health Area and to describe the demographic, assistance and diagnostic data following recommendations of assessment of disease morbidities and use of health systems at a regional level.

This is an observational descriptive study that prospectively recorded ambulatory demand of first neurological visits during the year 2008. Demographic, assistance and diagnostic data of the 1,341 patients that attended the neurology clinic were recorded.

The 1,524 visits requested was equivalent to a demand of 15.08 visits per inhabitant older than 14 and per year. Twelve per cent of patients did not attend the requested visit. The mean age of the total sample was 56.29 years, of which 60.99% were women and 42.20% were older than 65 years. A total of 76% were sent by their general practitioner, of which 70% were non-urgent. The most common referral causes were headache (26%) and dementia (15%), and the diagnoses at the end of the neurology visit were headache (27%) and "no neurological disease" (19%). Among patients older than 65 years, dementia and movement disorders made up 34% of neurological diagnoses. After the first visit, 59% of patients were discharged to their general practitioner.

Headache is the most common complaint for referral to neurology in our region. Advanced age increases the demand due to a higher prevalence of neurodegenerative diseases. The high proportion of direct discharges suggests a poor selection of the patients referred from primary care and underlines the need for a more rational patient selection for referral to secondary care.