Background Musculoskeletal diseases are the leading cause of disability in the world and have a high impact on direct (health) and indirect (labor) costs. Labor casualties in Spain, when temporary, are known as temporary work disability (TWD). Since 2013, follow-up of patients with TWD (when the origin of the disease is a musculoskeletal condition) is being carried out in a monographic consultation within the external consultations of the Rheumatology Service of the Hospital Clínico Universitario de Valladolid.
Objectives To describe the experience of the last 6 months in the consultation of temporary musculoskeletal incapacities (TWDMSDs) of the Hospital Clínico Universitario de Valladolid.
Methods The TWDMSDs consultation is operational 2 days a week. The referral system is direct from Medical Inspection via email (1st part confirmatory work leave). The patients come from 7 Health Centers (population 82,000 people). The agenda is configured daily according to the emails sent, contacting the patients by telephone, excluding those with trauma, surgeries, pregnancies, non-localized, rejection or discharge. The assessment of the patients in consultation, according to usual clinical practice. A medical report is issued (medical history, physical examination, completed or requested tests, recommendations and treatment). The data are collected in SPSS, proceeding to its subsequent analysis.
Results During the last six months of follow-up, 354 emails have been received. A total of 106 patients were evaluated, with the following characteristics: 54.3% women and 45.7% men, mean age 43.4 years, 95% performed physical work. Axial pathology was observed in 67.8% of cases and peripheral in 32.2%. The patients evaluated with some rheumatic pathology reached 96%. The average delay from the start of the work leave to the email was 12.2 days, and from the start of the work leave to the first consultation of 6.7 days (including weekends). 65.4% of the patients were discharged from the TWDMSDs agenda in the 1st consultation, without requiring interconsultations or requests for diagnostic tests, with an infiltration of 8% of the patients, arthrocentesis at 2%, ultrasound at 28% and Exercise guidelines were given to 76% of patients. The mean number of consultations up to discharge was 1.3. The mean time from onset of discharge to discharge was 21.1 days and from the first consultation until discharge by Rheumatology was 6.6 days.
Conclusions The TWDMSDs consultation makes possible the early detection of rheumatologic musculoskeletal pathology, allowing an early action that minimizes the number of requested tests and interconsults generated and achieves an early diagnosis and treatment of patients, with the consequent benefits that this entails. The patients evaluated in consultation are mainly of average age, with physical work, mechanical pathology, resolution of the problem that causes the TWD and reincorporation to the working life of early form. In the discharge report, recommendations are included to minimize future casualties (work refocus, orthotics, exercises, treatment regimens in the event of a recurrence of symptoms) and explain the importance of being actively involved in their pathology to prevent progression.
Disclosure of Interest None declared