[Analysis of referrals of new patients to the rheumatology section of a tertiary hospital].
BACKGROUND
The prevalence of rheumatic diseases is approximately 15% in the general population.


OBJECTIVE
To assess the concordance between the original and final diagnosis of patients referred to a rheumatology unit.


METHODS
During 2000, all new patients referred to the rheumatology section of Temuco General Hospital were recorded. The concordance between the referral diagnosis given by general practitioners or general internists and the final diagnosis reached at the rheumatology unit was analyzed using the Kappa index. The modified version of the American College of Rheumatology nomenclature was used as reference.


RESULTS
The clinical records of 787 outpatients, 83% females, aged 54.7 +/- 14 years old, were analyzed. Twenty seven percent of patients were referred with the diagnosis of connective tissue diseases, 26% with extra articular diseases and 24% with osteoarthritis. The concordance between referral and final diagnosis reached at the rheumatology unit had a kappa of 0.6 for general practitioners and 0.72 for general internists.


CONCLUSIONS
Although the overall concordance between referral diagnosis, given by general practitioners or general internists, and final rheumatological diagnosis is good, there are still major discrepancies that should be improved.
Werner
Ana María
AM
Unidad de Reumatología, Servicio de Medicina Interna, Hospital Regional de Temuco, Facultades de Medicina, Ingeniería, Ciencias y Administración, Universidad de La Frontera, Temuco, Chile. amwerner@terra.es
Leal
Hellmuth
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011446:Prospective Studies; D012017:Referral and Consultation; D012216:Rheumatic Diseases / Q000175:diagnosis*; D012219:Rheumatology