Re-referrals to a Danish regional spine centre.

IF 1.2 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Danish medical journal Pub Date : 2025-09-09 DOI:10.61409/A12240871

Anders Hansen, Casper Nim, Dorthe Ziegler, Jakob Blaabjerg Espesen, Natalie Hong Siu Chang, Søren O'Neill, Steen Harsted

{"title":"Re-referrals to a Danish regional spine centre.","authors":"Anders Hansen, Casper Nim, Dorthe Ziegler, Jakob Blaabjerg Espesen, Natalie Hong Siu Chang, Søren O'Neill, Steen Harsted","doi":"10.61409/A12240871","DOIUrl":null,"url":null,"abstract":"Introduction: In Denmark, general practitioners are the primary providers, referring patients to specialised spine care. Re-referral may indicate unresolved spinal pain, but can also reflect inefficiencies in patient management. This study determined the rate of re-referrals to a Danish regional spine centre within 500 days of the initial visit and identified patient-specific factors associated with re-referrals.Methods: A cohort study of patients at the Spine Centre of Southern Denmark was conducted from January 2019 to December 2023. Re-referrals were defined as visits between 50 and 500 days after the initial consultation. Factors investigated included referral diagnoses, patient-reported outcomes and clinical services initiated. Multivariable logistic regression identified associations with re-referral.Results: Among 30,872 patients, re-referrals were observed in 10.3% (n = 3,095). Previous back surgery (OR = 1.23), pain medication (OR = 1.37), MRI referrals (OR = 1.6), provision of rehabilitation plans (OR = 1.26), extremity pain (OR = 1.02) and loneliness (OR = 1.02) were associated with increased odds of re-referrals. In contrast, non-specific spinal pain diagnosis reduced the likelihood (OR = 0.83). Model discrimination was limited (Tjur's coefficient of discrimination (D) = 0.017), indicating weak predictive performance.Conclusions: Re-referrals were common. Certain clinical factors were associated with re-referrals to a spine centre. Still, their predictive value was limited, making it difficult to recommend strategies to reduce re-referrals from general practice.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 10","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Danish medical journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.61409/A12240871","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: In Denmark, general practitioners are the primary providers, referring patients to specialised spine care. Re-referral may indicate unresolved spinal pain, but can also reflect inefficiencies in patient management. This study determined the rate of re-referrals to a Danish regional spine centre within 500 days of the initial visit and identified patient-specific factors associated with re-referrals.

Methods: A cohort study of patients at the Spine Centre of Southern Denmark was conducted from January 2019 to December 2023. Re-referrals were defined as visits between 50 and 500 days after the initial consultation. Factors investigated included referral diagnoses, patient-reported outcomes and clinical services initiated. Multivariable logistic regression identified associations with re-referral.

Results: Among 30,872 patients, re-referrals were observed in 10.3% (n = 3,095). Previous back surgery (OR = 1.23), pain medication (OR = 1.37), MRI referrals (OR = 1.6), provision of rehabilitation plans (OR = 1.26), extremity pain (OR = 1.02) and loneliness (OR = 1.02) were associated with increased odds of re-referrals. In contrast, non-specific spinal pain diagnosis reduced the likelihood (OR = 0.83). Model discrimination was limited (Tjur's coefficient of discrimination (D) = 0.017), indicating weak predictive performance.

Conclusions: Re-referrals were common. Certain clinical factors were associated with re-referrals to a spine centre. Still, their predictive value was limited, making it difficult to recommend strategies to reduce re-referrals from general practice.

Funding: None.

Trial registration: Not relevant.

查看原文本刊更多论文

转介到丹麦地区脊柱中心。

简介：在丹麦，全科医生是主要提供者，将患者转介到专门的脊柱护理。重新转诊可能表明未解决的脊柱疼痛，但也可以反映病人管理效率低下。本研究确定了首次就诊后500天内丹麦地区脊柱中心的转诊率，并确定了与转诊相关的患者特异性因素。方法：2019年1月至2023年12月，对丹麦南部脊柱中心的患者进行了一项队列研究。重新转介的定义是在初次咨询后50至500天内的访问。调查的因素包括转诊诊断、患者报告的结果和开始的临床服务。多变量逻辑回归确定了与再转诊的关联。结果：在30,872例患者中，10.3% （n = 3,095）观察到再转诊。既往背部手术（OR = 1.23）、止痛药（OR = 1.37）、MRI转诊（OR = 1.6）、提供康复计划（OR = 1.26）、肢体疼痛（OR = 1.02）和孤独感（OR = 1.02）与再转诊的几率增加相关。相比之下，非特异性脊柱疼痛诊断降低了可能性（OR = 0.83）。模型判别有限（Tjur判别系数(D) = 0.017），预测性能较弱。结论：转诊是常见的。某些临床因素与再转诊到脊柱中心有关。尽管如此，他们的预测价值是有限的，这使得很难推荐减少转诊的策略。资金:没有。试验注册：不相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Danish medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.