发生的宫椎间盘的转诊和手术治疗的国家差异
Mikkel Kjeldgaard1,2, Berit Schiøttz-Christensen3, Janus Nikolaj Laust Thomsen4
1Department of Neurosurgery, Department of Clinical Medicine, Aalborg University Hospital, 9000, Aalborg, Denmark. m.kjeldgaard@rn.dk.
Acta neurochirurgica
|December 1, 2025
概括
在丹麦,宫椎间盘 (CDH) 转诊途径和手术率存在区域差异. 对于对保守护理不耐药的患者,需要最佳的治疗途径.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 整形外科手术 整形外科手术
- 公共卫生政策 公共卫生政策
背景情况:
- 宫椎间盘 (CDH) 对工作年龄的成年人产生重大影响.
- 对于CDH从初级保健过渡到专家评估的理解有限.
- 转诊途径的区域差异可能会影响CDH管理和患者的治疗结果.
研究的目的:
- 调查丹麦五个医疗保健地区CDH转诊途径的区域差异.
- 分析这些地区对CDH手术干预率的变化.
- 评估推途径对CDH患者工作能力结果的影响.
主要方法:
- 利用了2017年发生CDH的4322名年龄在18-65岁之间的个人的国家注册数据.
- 按医疗保健地区和初始专家联系部门 (医疗,外科,急诊) 分层的患者.
- 评估工作能力 (低,中等,高) 诊断前一年,并跟踪两年后专家联系.
主要成果:
- 对于CDH的专业医疗保健联系人来说,可比的国家比率 (1万居民中有12-13人).
- 在手术率 (793-2,320每10,000名患者) 中显著的区域差异.
- 转诊途径和手术率在不同地区有很大差异,紧急转诊率显示了最高的手术率 (每10,000人中有2,507人).
- 高基线工作能力的患者 (87%) 在六个月内恢复了诊断前的能力;低能力的患者 (5%) 在两年内表现出最小的改善.
结论:
- 尽管全国推率相似,但在CDH进入途径和手术干预方面存在显著的区域差异.
- 这些发现突出了对CDH患者优化专门临床途径的需要,CDH患者对最初的保守治疗没有反应.
- 需要进一步的研究来规范护理和改善不同地区CDH患者的治疗结果.
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