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首页> 外文期刊>Journal of neurology >Health services utilization of patients with vertigo in primary care: A retrospective cohort study
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Health services utilization of patients with vertigo in primary care: A retrospective cohort study

机译：初级保健中眩晕患者的卫生服务利用率：一项回顾性队列研究

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摘要

Vertigo and dizziness count among the most frequent symptoms in outpatient practices. Although most vestibular disorders are manageable, they are often under- and misdiagnosed in primary care. This may result in prolonged absence from work, increased resource use and, potentially, in chronification. Reliable information on health services utilization of patients with vertigo in primary care is scarce. Retrospective cohort study in patients referred to a tertiary care balance clinic. Included patients had a confirmed diagnosis of benign paroxysmal positional vertigo (BPPV), Meni鑢e's disease (MD), vestibular paroxysmia (VP), bilateral vestibulopathy (BVP), vestibular migraine (VM), or psychogenic vertigo (PSY). All previous diagnostic and therapeutic measures prior to the first visit to the clinic were recorded. 2,374 patients were included (19.7 % BPPV, 12.7 % MD, 5.8 % VP, 7.2 % BVP, 14.1 % VM, 40.6 % PSY), 61.3 % with more than two consultations. Most frequent diagnostic measures were magnetic resonance imaging (MRI, 76.2 %, 71 % in BPPV) and electrocardiography (53.5 %). Most frequent therapies were medication (61.0 %) and physical therapy (41.3 %). 37.3 % had received homoeopathic medication (39 % in BPPV), and 25.9 % were treated with betahistine (20 % in BPPV). Patients had undergone on average 3.2 (median 3.0, maximum 6) diagnostic measures, had received 1.8 (median 2.0, maximum 8) therapies and 1.8 (median 1.0, maximum 17) different drugs. Diagnostic subgroups differed significantly regarding number of diagnostic measures, therapies and drugs. The results emphasize the need for establishing systematic training to improve oto-neurological skills in primary care services not specialized on the treatment of dizzy patients.
机译：眩晕和头晕是门诊实践中最常见的症状。尽管大多数前庭疾病是可以控制的，但在初级保健中常常被误诊或误诊。这可能导致长时间的缺勤，增加的资源使用，并可能导致时间同步。在初级保健中缺乏有关眩晕患者健康服务利用的可靠信息。对患者的回顾性队列研究转诊至三级护理平衡诊所。纳入的患者确诊为良性阵发性位置性眩晕（BPPV），梅尼埃斯病（MD），前庭阵发性失眠（VP），双侧前庭病（BVP），前庭偏头痛（VM）或心因性眩晕（PSY）。记录首次就诊之前所有以前的诊断和治疗措施。包括2 374名患者（其中BPPV为19.7％，MD为12.7％，VP为5.8％，BVP为7.2％，VM为14.1％，PSY为40.6％），61.3％进行了两次以上的咨询。最常见的诊断措施是磁共振成像（MRI，BPPV为76.2％，71％）和心电图检查（53.5％）。最常见的疗法是药物治疗（61.0％）和物理疗法（41.3％）。 37.3％接受过顺势疗法药物治疗（BPPV中为39％），25.9％接受倍他司汀治疗（BPPV中为20％）。患者平均接受了3.2（中位数3.0，最多6种）诊断措施，接受了1.8（中位数2.0，最多8种）治疗和1.8（中位数1.0，最多17）种不同的药物。诊断亚组在诊断措施，治疗方法和药物数量方面存在显着差异。结果强调需要建立系统的培训以提高初级保健服务中耳神经的技能，而不是专门针对头晕患者的治疗。

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