Background

Understanding the care pathway is essential to identify how to effectively treat spinal disorders. However, there is no specific data on the pathway of these individuals in the Health Care Networks (HCN) in Brazil.

Objective

To investigate the pathway of individuals with non-specific spinal disorders (NSD) in the HCN in the Federal District, Brazil, and verify the interventions adopted, and to test whether sociodemographic and clinical variables predict the number of imaging tests, prescribed medication, and the first HCN access.

Methods

Retrospective study that analysed electronic records of 327 individuals with NSD between 2012 and 2018. Generalized linear models estimated the association between sociodemographic and clinical data and number of drugs prescribed and imaging tests requested. Multinomial logistic regression estimated the association between clinical and demographic variables and setting of first access.

Results

The median age was 57 years, and 75.5% were women. Emergency Department (ED) was the most accessed setting (43.7%), and back pain was the most prevalent condition (84.5%). Most individuals underwent imaging tests (60%) and drug prescriptions (86%). Physical exercises were prescribed to 13%, and 55% were referred to physical therapy. Women were more likely to first access the ED.

Conclusion

The ED was the most used setting by people with NSD. Few participants received exercise prescriptions and half were referred to physical therapists. Individuals who used outpatient clinics and primary care received less drug prescriptions, and women were more likely to first access the ED. Increasing age was associated with greater chance of first accessing Outpatient Clinics.

中文翻译：

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巴西联邦区医疗保健网络中脊柱疾病患者的护理途径：一项回顾性研究

背景

了解护理途径对于确定如何有效治疗脊柱疾病至关重要。然而，巴西医疗保健网络（HCN）中没有关于这些人的路径的具体数据。

客观的

调查巴西联邦区 HCN 中非特异性脊柱疾病 (NSD) 患者的路径，验证所采取的干预措施，并测试社会人口统计学和临床​​变量是否可以预测影像学检查、处方药物和治疗的数量。首次HCN接入。

方法

回顾性研究分析了 2012 年至 2018 年间 327 名 NSD 患者的电子记录。广义线性模型估计了社会人口统计学和临床​​数据与处方药物数量和要求的影像学检查之间的关联。多项逻辑回归估计了临床和人口统计学变量与首次访问设置之间的关联。

结果

中位年龄为 57 岁，其中 75.5% 为女性。急诊科 (ED) 是最常见的情况 (43.7%)，背痛是最常见的病症 (84.5%)。大多数人接受了影像学检查（60%）和药物处方（86%）。13% 的人接受体育锻炼，55% 的人接受物理治疗。女性更有可能首先去急诊室。

结论

急诊室是 NSD 患者最常使用的场所。很少有参与者收到运动处方，一半被转介给物理治疗师。使用门诊诊所和初级保健的个人收到的药物处方较少，女性更有可能首先去急诊室。年龄增长与首次就诊门诊的机会增加相关。