A rheumatology consultancy program with general practitioners in Catalonia, Spain.
OBJECTIVE
To analyze the influence of a primary care rheumatology consultancy program on the number of referrals to the rheumatology unit (RU), the waiting times for new visits at the RU, and the satisfaction of the general practitioners (GPs) with respect to the RU.


METHODS
From September 2003 to August 2004 a consultancy program was carried out by 4 consultant rheumatologists of the RU and 117 GPs, consisting of biweekly clinical sessions in which cases were commented upon prior to referral and local clinical guidelines on 10 musculoskeletal disorders were discussed. Referral rates to the RU, 5-item GP satisfaction questionnaires (patient accessibility to the RU, information obtained after the visit, GP accessibility to the RU, communication between levels, and resolution capacity of the RU), waiting times, and number of patients waiting for a visit were analyzed. These variables were compared before and after the intervention.


RESULTS
New referrals to the RU significantly diminished during the intervention year (1141 vs 1652 in the previous year, 5.5% patients referred vs 8.1% previous year; p < 0.0001). GP satisfaction improved significantly for all items (p < 0.0001). The waiting time for first non-urgent visit diminished from 7 months to 1 month (p < 0.01) during the intervention year, and the number of patients on the waiting list was reduced from 790 to 51 (p < 0.05).


CONCLUSIONS
A consultancy program between rheumatologists of a RU and GPs of the same area showed improvement in GP satisfaction and reduced the number of referrals to the RU and the waiting times for new non-urgent visits.
Surís
Xavier
X
Rheumatology Unit, Department of Internal Medicine, Fundació Hospital/Asil de Granollers, Barcelona, Spain. xsuris@fhag.es
Cerdà
Dacia
D
Ortiz-Santamaría
Vera
V
Ponce
Andrés
A
Simón
José Luís
JL
Calvo
Elena
E
Torras
Maria Josep
MJ
Hoyo
Guillermo
G
D006306:Health Surveys; D006801:Humans; D017063:Outcome Assessment, Health Care; D010821:Physicians, Family; D011320:Primary Health Care / Q000379:methods; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D012219:Rheumatology / Q000458:organization & administration*; D013030:Spain; D014850:Waiting Lists