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[Analysis of the use of radiology in primary health care]
M A Delgado Nicolás1, F J Peces Morate
1Especialistas en Medicina Familiar y Comunitaria, Centro de Salud Embajadores, INSALUD, Madrid.
Objective:
To analyse the quality of requests in primary care for radiological investigations, by determining both their effectiveness and modifications in the doctors' therapeutic approach and diagnostic opinion caused by the radiological findings.
Design:
Longitudinal, retrospective study.
Setting:
The Embajadores 1 Primary Care team (PCT), Madrid, during 1993.
Participants:
203 radiologies on a significant sample of the PCT's catchment population with a clinical history.
Measurements And Results:
Radiology was requested for 12% of patients seen: males 39.40% and women 60.59%. Average age was 56.64 +/- 1.41. Commonest requests were for: bone (41.87%), thorax (25.12%), abdominal ecography (9.36%) and digestive system (8.37%). Pathology was discovered in 67.98% of cases, with these results considered relevant in 26.60%. The radiological findings caused 18.72% of doctors to change their therapeutic approach or diagnostic opinion. The radiological investigations with most relevant findings were: mammographies (38.46%), barium meals (35.29%) and abdominal ecographies (31.57%).
Conclusions:
Bone and thoracic radiologies account for almost 70% of requests. Despite the high percentage of pathological radiographies, only 19% of the x-rays caused any change in the doctor's attitude, which makes us think the correct indication for each case must be analysed.