Primary care in the management of common orthopaedic problems.
BACKGROUND
Improving national healthcare services through the enhancement of primary care, is a major challenge in many countries.


OBJECTIVE
To assess the prevalence of those orthopaedic cases that could be managed by a primary healthcare system.


METHODS
Between January 2001 and January 2006 a total of 39 172 patients attended the orthopaedic emergency department (ED) of Laikon University Hospital. All cases were included in this retrospective study. The registry of the orthopaedic ED was analysed by age, sex and clinical diagnosis. All patients were evaluated by a specialist. Classification of the cases was based on the main symptom of those seeking care.


RESULTS
A total of 39 172 patients visited the orthopaedic ED; 17 040 (43.5%) of these patients were stratified in six major groups of diagnosis. Back pain (17.1%) was the most common reason for seeking care in the orthopaedic ED, followed by ankle injuries (10.3%). The admission rate was 1.2%, and X-ray examination was necessary for 93.4% (15 220) of patients.


CONCLUSIONS
This study confirms the widely held view that most cases attending the orthopaedic ED could have been managed by appropriately equipped primary care settings. In this context, the role of general practitioners should be re-appraised and strengthened.
Marinos
George
G
General Practice Department, Athens University Medical School, Laiko Hospital, Athens, Greece. marinosgiorgos@hotmail.com
Giannopoulos
Athanasios
A
Vlasis
Kostas
K
Michail
Othon
O
Katsargyris
Athanasios
A
Gerasimos
Siasos
S
Elias
Gialafos
G
Klonaris
Chris
C
Griniatsos
John
J
Stefanos
Provlengios
P
Vasileiou
Ioanna
I
D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000628:therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies