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AB0229 Influence of rheumatologist in primary care
  1. MC García Gómez,
  2. C Galisteo,
  3. MP Lisbona,
  4. M Sanmartí,
  5. M Castellanos,
  6. N Navarro,
  7. C Alegre
  1. Rheumatology, Hospital Malalties Rheumàtiques, Barcelona, Spain

Abstract

Objectives To study if there are differences between the type and frequency of pathologies visited in a surgery of rheumatology hospital before and after the presence of rheumatologist in primary care (PC).

Methods Descriptive and retrospective study in the urban medium from Barcelona. We revised the historial clinic from first six months period in 1995 (without rheumatologist in PC) and 2000 (when the rheumatologist goes once per week to the primary care centre). We analysed the variables age, sex and principal diagnosis from all the first visits attended. We assembled the diagnosis in 10 groups: infectious arthritis (1), connective tissue disorders (2), crystal-related arthropathies (3), inflammatories arhropaties (4), osteoarthritis and related disorders (5), regional pain problems and soft tissue (6), muscular diseases (7), tumours and paraneoplastic syndromes in the musculoskeletal system (9) and others pathologies (10). For the statistic test we use the chi-squared test to contrast of proportions and the Fisher´s exact test when the expected effectives were lower than 5.

Results In 1995 we have done 779 first visits (with 2.3% of loses the fact is not to have the historial clinic) and from 2000, 411 (11% of loses caused by the same matter). In 1995 the average age was 55 years (3–86), the distribution per sex was: 185 men (24%) and 594 women (76%), and per pathology: group 1, 2(0.2%), group 2, 45 (5.72%), group 3, 18(2.3%), group 4, 23 (2.9%), group 5, 453(58.1%), group 6, 152(19.5%), group 7, 1(0.12%), group 8, 55(7%), group 9, 4(0.5%), group 10, 26(3.3%). In 2000 the average age was 55 years (5–87), the distribution per sex was:126 men (30%) and 285 women (70%), and per pathology: group 1, 1(0.2%), group 2, 38(9.2%), group 3, 14 (3.4%), group 4,21 (5.1%), group 5, 200 (48.6%), group 6 89 (21.6%), group 7, 0, group 8, 31(7.5%), group 9, 3 (0.73%), group 10, 14(3.4%). We found significant difference between both years in the groups 2 (p = 0.025) and 5 (p = 0.0002).

Conclusion The total numbers of first visits in the hospital done in 2000 were half less than in 1995 (above all in degeneration pahology), without being geographic and demographic variations. The incorporation of the rheumatologist in PC would improve the quality assistance in the hospital and also allow an early diagnosis from many rheumatic illness that would benefit from it.

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