Patients with shoulder complaints in general practice: consumption of medical care.
OBJECTIVE
To describe the medical consumption [general practitioner (GP) consultation, referrals, medication consumption] of patients with shoulder complaints in general practice.


METHODS
Data were obtained from a primary-care medical registration network. All patients aged ≥18 years with new shoulder complaints who consulted their general practitioner in 1998 were included, and were followed 10 years beyond the initial consultation.


RESULTS
A total of 526 incident cases were identified (average age 47 years, 65% women and average follow-up 7.6 years). Nearly half of the patients consulted their GP only once. For 79% of those patients, a wait-and-see policy or a prescription for NSAIDs sufficed. During follow-up, 65% of all patients were prescribed medication. Medication consumption was significantly higher among men than women, and higher for the 45- to 64-year age group compared with the younger group. A total of 199 patients were referred, of which 84% was to a physiotherapist and 16% to secondary care. Only two patients had surgery, performed by an orthopaedic surgeon. The GP recorded a diagnosis in only 14% of patients; rotator cuff disorder being the most common.


CONCLUSIONS
Nearly half of patients with a new shoulder complaint consult their GP only once. Medical consumption in general practice is highest for male shoulder patients and the 45- to 64-year age group. Shoulder problems are mainly an issue for primary care.
Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. o.dorrestijn@orth.umcg.nl
Oscar
O
Dorrestijn
Kim
K
Greving
Willem Jan
WJ
van der Veen
Klaas
K
van der Meer
Ron L
RL
Diercks
Jan C
JC
Winters
Martin
M
Stevens
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D011320:Primary Health Care / Q000191:economics; D012017:Referral and Consultation; D012737:Sex Factors; D020069:Shoulder Pain / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult