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Re-referrals to a Danish regional spine centre
Anders Hansen1,2, Casper Nim1,2,3, Dorthe Ziegler1,2
1Spine Centre of Southern Denmark, University Hospital of Southern Denmark - Kolding Hospital.
Introduction:
In Denmark, general practitioners are the primary providers, referring patients to specialised spine care. Re-referral may indicate unresolved spinal pain, but can also reflect inefficiencies in patient management. This study determined the rate of re-referrals to a Danish regional spine centre within 500 days of the initial visit and identified patient-specific factors associated with re-referrals.
Methods:
A cohort study of patients at the Spine Centre of Southern Denmark was conducted from January 2019 to December 2023. Re-referrals were defined as visits between 50 and 500 days after the initial consultation. Factors investigated included referral diagnoses, patient-reported outcomes and clinical services initiated. Multivariable logistic regression identified associations with re-referral.
Results:
Among 30,872 patients, re-referrals were observed in 10.3% (n = 3,095). Previous back surgery (OR = 1.23), pain medication (OR = 1.37), MRI referrals (OR = 1.6), provision of rehabilitation plans (OR = 1.26), extremity pain (OR = 1.02) and loneliness (OR = 1.02) were associated with increased odds of re-referrals. In contrast, non-specific spinal pain diagnosis reduced the likelihood (OR = 0.83). Model discrimination was limited (Tjur's coefficient of discrimination (D) = 0.017), indicating weak predictive performance.
Conclusions:
Re-referrals were common. Certain clinical factors were associated with re-referrals to a spine centre. Still, their predictive value was limited, making it difficult to recommend strategies to reduce re-referrals from general practice.
Funding:
None.
Trial Registration:
Not relevant.
