Referral patterns of military family medicine clinics in Tabuk, Saudi Arabia
أنماط الإحالة لعيادات طب الأسرة العسكرية في تبوك بالسعودية
Referral patterns of military family medicine clinics in Tabuk, Saudi Arabia
الكلمات المفتاحية Keywords[عدل]
- Referral patterns
- family medicine clinics
- military
- Tabuk
- Saudi Arabia
المؤلفين[عدل]
Abdulaziz F. Al-Kaabba (1), Abdelshakour M. Abdalla (2), Abdalla A. Saeed (2), Abdulmohsen H. AlZalabani (2), Hashim H. Ahmad (3), Ali A. Mustafa (4) (1) Associate Dean, Faculty of Medicine, King Fahad Medical City, King Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia (2) Staff members, Community Medicine Department, Faculty of Medicine, King Saud Bin AbdulAziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia (3) Staff member, Family Medicine Department, Faculty of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia (4) Head of Basic-science Department, Faculty of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia
Correspondence: Dr. Abdel Shakour M. Abdalla, Community Medicine Consultant, Faculty of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia, PO Box 59046 Riyadh 11525, Kingdom of Saudi Arabia. Tel. +966 (1) 2889999 ext. 7513.
Email: Abdallaali63@hotmail.com
ملحوظات[عدل]
- Subjects with multi-morbidity were referred more often than those with one morbidity, but this difference was not significant
- Elderly referral in Fam Med clinic in Tabuk 20%
- تعريف المسنين فوق 65 عام
- higher referrals for internal medicine included females, older subjects, and patients with acute morbidity.
- Referral for cardiology was significantly associated with males, older age, and those with chronic morbidities
- For the surgery department, Regression analysis showed that only age and location were significant predictors of referrals.
- Specialists in the hospital gave feedback reports to family physicians for only 13.2% of the referred patients (219 out of 1,653).
- Feedback was significantly associated with distant clinics, males, infants, patients with chronic comorbidity, and asthmatics. Patients
- المؤلفين ربما يتحفظون على تصنيف المسنين من عمر 65 عام لوجود علامة إستفهام (إذا كانت مقصودة وليست خطأ مطبعي) The referral rates positively correlated with age, with less than 8% of patients less than 15 years old being referred; patients older than 15 had a referral rate exceeding 13%. Similar trends were reportedfrom other studies where referral increases steadily by age group, with 7.5% of patients aged 0-15 years referred compared to 21.1% of patients in the ?65 age group(18). Other studies, however, reported different referral rates according to age. The highest referral rate was in the middle-aged group (35-64), with the pediatric and geriatric age groups having rates approximately halve this(27).
- نتيجة هامة أنه لا توجد علاقة بين معدل الإحالة وكم المراضة عند المرضى (إشكالية المراضة العالية في المسنين) وبالتالي لا يوجد داعي للوصم In Tabuk, patients not suffering from bronchial asthma were referred significantly more because a special bronchial asthma clinic is conducted within family clinics each week. Specialists from hospitals usually participate in these clinics, thus it is not surprising that referrals of asthmatic patients were very low. No significant relationship between referrals and presence or absence of other morbidities was found, which is in contrast to other studies reporting a stronger association between referrals and chronic morbidity(21).
- هام لأطباء المسنين ومقدمي الرعاية الصحية للمسنين تعلم مهارات طب العيون والأنف والأذن والحنجرة والجلدية In this study we found that the chance of referral to specialist care for diseases related to the eye, skin, and ENT were higher than other morbidities. This shows that there may be a need for further training in these subjects, enabling a family physician to minimize the burden on these specialties.
- تسبة الردود المرتجعة المنخفضة نسبياً بمعدل أقل من 15% متوقع حدوث نفس الشئ في الرعاية المنزلية (أحد مشاكلها هو عدم وجود إتصال كافي بين أطبائها والأخصائيين بالمستشفى) وربما يعكس وجود ردود مرتجعة للأطفال تحيز غير مقصود بسبب إستشعار الأهمية وبالنسبة لمن هم من عيادات بعيدة بالتأكيد هي إشكالية هامة لخدمات الرعاية المنزلية التي غالباً ما تكون محليةFeedback letters from specialists in the hospital to referring physician from family clinic were sent for approximately 13% of patients; feedback was significantly more common with infants and patients with chronic comorbidity and patients from far clinics. Both infants and patients with comorbidity are high-risk groups that may require special handling, thus specialists involvement is often appropriate. Specialists should be encouraged to provide feedback, which is not just common courtesy; communication between general practitioners (GPs) and specialists is important(35).
Specialists expect the GP to provide information concerning the problem to be addressed along with adequate patient history; GPs expect a clear response from the specialist regarding diagnosis and management, as well as justification for the course of action, and patients expect clear explanation of the diagnosis, treatment, and follow-up requirements. When these expectations remain unmet, GPs, specialists, and patients end up dissatisfied with the referral process(36). A digital format composed by both parties for both a referral letter and a specialist’s report should be developed(37).
