Characteristics of early arthritis units that may be associated with better referral efficiency: survey of SERAP units
Características de una unidad de artritis precoz que mejoran la eficiencia de la derivación: encuesta a las unidades SERAP
Virginia Villaverdea, Miguel Ángel Descalzob, Loreto Carmonab,
, Miriam Basconesc, Jordi Carbonelld, Grupo de estudio SERAP ◊
Corresponding author
loreto.carmona@ser.es
Corresponding author. Unidad de Investigación, Sociedad Española de Reumatología, Calle Marqués del Duero, 5, 1.°, 28001 Madrid, Spain.
Corresponding author. Unidad de Investigación, Sociedad Española de Reumatología, Calle Marqués del Duero, 5, 1.°, 28001 Madrid, Spain.
a Sección de Reumatología, Hospital Universitario de Móstoles, Madrid, Spain
b Unidad de Investigación, Sociedad Española de Reumatología, Madrid, Spain
c Departamento Médico, Abbott Laboratories, Madrid, Spain
d Servicio de Reumatología, Hospital del Mar, Institut Municipal Atenció Sanitaria, Barcelona, Spain
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Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author. Unidad de Investigación, Sociedad Española de Reumatología, Calle Marqués del Duero, 5, 1.°, 28001 Madrid, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características de una unidad de artritis precoz que mejoran la eficiencia de la derivación: encuesta a las unidades SERAP" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-07-19" "fechaAceptado" => "2010-11-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112782" "palabras" => array:6 [ 0 => "Survey" 1 => "Early arthritis" 2 => "Referral" 3 => "Primary Care" 4 => "Specialized care" 5 => "Health services" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112781" "palabras" => array:6 [ 0 => "Encuesta" 1 => "Artritis precoz" 2 => "Derivación" 3 => "Atención primaria" 4 => "Atención especializada" 5 => "Servicios de salud" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To identify characteristics of early arthritis units, that may be associated with better referral eficiency.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A national survey of the 36 early arthritis units (EAU) in Spanish Rheumatology Units in 2004 (SERAP project). Survey collected information about general practitioners (GP) educational program to improve knowledge and practical skills of early arthritis, networking and feed-back system and referral efficiency. EAU were classified in two groups according to 25% and 50% of inappropriate referral process, respectively.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Thirty four of the 36 (94%) EAU, answered the survey. GP were trained in only 1 medical meeting in the primary care clinic, with one or more rheumatologists responsible of GP education. Fourteen of the 34 EAU (42.4%) regularly interacted with GP and only 20 (39.4%) contacted the GP who were responsible for the wrong referral process. Median lag time for referral to the Rheumatology out-patient clinic, was 73 days (15-365 days). The percentage of wrongly referred patients was between 0 and 80% (38%±21). Only 10 EAU (27.8%) referred patients appropriately according to the strictest criteria (25% of inappropriate referral) and 27 EAU (75%), according to 50% of inappropriate referral criteria.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Only two aspects of the EAU implementation strategy were associated with better referral efficiency: 1) interaction with the GP responsible of the inappropriate referral process and 2) a lower median lag time for referral to the Rheumatology out-patient clinic.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Identificar las características de una unidad de artritis precoz (UAP) que se asocian con una mejor eficiencia de la derivación desde atención primaria.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Encuesta a 36 UAP creadas en centros hospitalarios de toda España en el año 2004, mediante el programa SERAP. Las preguntas de la encuesta recogían detalles del proceso formativo de los médicos de atención primaria (MAP), del sistema de feedback, liderazgo y derivación. Se consideró que una UAP era tanto más eficiente cuanto menor fuera el número de pacientes mal derivados. Para el análisis se utilizaron dos dinteles de derivación errónea: 25 y 50%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Treinta y cuatro UAP (94%) participaron en la encuesta. La mayoría (62%) realizó la formación de los médicos en una sesión por centro de atención primaria. Catorce de las 34 UAP (42,4%) informaron regularmente del estado del proyecto a sus MAP y sólo 20 (39,4%) contactaron con los MAP que estaban derivando mal a los pacientes. El tiempo de espera medio para una primera consulta en Reumatología fue de 73 días (15-365 días). El porcentaje de pacientes mal derivados osciló entre el 0 y el 80% (38%<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21). Sólo 10 UAP (27,8%) tenían una derivación aceptable, según el dintel más estricto (25% de derivación errónea). Hasta 27 UAP (75%) cumplían criterios de derivación aceptable si se establecía el dintel en el 50%.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Sólo dos aspectos de la estrategia adoptada por las UAP estaban asociados con la eficiencia en la derivación: 1) el hecho de que se contactara con los MAP que no estaban derivando bien y 2) una menor lista de espera en la consulta general de Reumatología.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara">Annex 1 includes a list of its components.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 15 | 20 |
| 2024 October | 18 | 47 | 65 |
| 2024 September | 15 | 31 | 46 |
| 2024 August | 27 | 37 | 64 |
| 2024 July | 23 | 34 | 57 |
| 2024 June | 29 | 34 | 63 |
| 2024 May | 29 | 26 | 55 |
| 2024 April | 21 | 22 | 43 |
| 2024 March | 32 | 28 | 60 |
| 2024 February | 27 | 24 | 51 |
| 2024 January | 24 | 22 | 46 |
| 2023 December | 25 | 24 | 49 |
| 2023 November | 20 | 23 | 43 |
| 2023 October | 25 | 28 | 53 |
| 2023 September | 25 | 38 | 63 |
| 2023 August | 19 | 20 | 39 |
| 2023 July | 18 | 16 | 34 |
| 2023 June | 20 | 34 | 54 |
| 2023 May | 18 | 18 | 36 |
| 2023 April | 14 | 8 | 22 |
| 2023 March | 16 | 25 | 41 |
| 2023 February | 21 | 18 | 39 |
| 2023 January | 13 | 20 | 33 |
| 2022 December | 20 | 32 | 52 |
| 2022 November | 27 | 33 | 60 |
| 2022 October | 15 | 17 | 32 |
| 2022 September | 19 | 34 | 53 |
| 2022 August | 27 | 44 | 71 |
| 2022 July | 14 | 42 | 56 |
| 2022 June | 17 | 45 | 62 |
| 2022 May | 30 | 58 | 88 |
| 2022 April | 29 | 43 | 72 |
| 2022 March | 40 | 60 | 100 |
| 2022 February | 16 | 41 | 57 |
| 2022 January | 15 | 34 | 49 |
| 2021 December | 22 | 46 | 68 |
| 2021 November | 17 | 51 | 68 |
| 2021 October | 35 | 62 | 97 |
| 2021 September | 28 | 47 | 75 |
| 2021 August | 30 | 51 | 81 |
| 2021 July | 20 | 38 | 58 |
| 2021 June | 29 | 45 | 74 |
| 2021 May | 21 | 45 | 66 |
| 2021 April | 72 | 124 | 196 |
| 2021 March | 29 | 36 | 65 |
| 2021 February | 31 | 27 | 58 |
| 2021 January | 33 | 20 | 53 |
| 2020 December | 19 | 22 | 41 |
| 2020 November | 30 | 22 | 52 |
| 2020 October | 14 | 14 | 28 |
| 2020 September | 32 | 27 | 59 |
| 2020 August | 24 | 19 | 43 |
| 2020 July | 14 | 15 | 29 |
| 2020 June | 29 | 28 | 57 |
| 2020 May | 22 | 19 | 41 |
| 2020 April | 27 | 12 | 39 |
| 2020 March | 19 | 9 | 28 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 4 | 0 | 4 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 5 | 1 | 6 |
| 2018 April | 27 | 9 | 36 |
| 2018 March | 41 | 13 | 54 |
| 2018 February | 23 | 4 | 27 |
| 2018 January | 37 | 3 | 40 |
| 2017 December | 19 | 3 | 22 |
| 2017 November | 16 | 5 | 21 |
| 2017 October | 19 | 7 | 26 |
| 2017 September | 19 | 8 | 27 |
| 2017 August | 9 | 6 | 15 |
| 2017 July | 19 | 7 | 26 |
| 2017 June | 30 | 11 | 41 |
| 2017 May | 24 | 10 | 34 |
| 2017 April | 27 | 6 | 33 |
| 2017 March | 18 | 2 | 20 |
| 2017 February | 9 | 1 | 10 |
| 2017 January | 21 | 7 | 28 |
| 2016 December | 104 | 11 | 115 |
| 2016 November | 54 | 4 | 58 |
| 2016 October | 104 | 14 | 118 |
| 2016 September | 66 | 4 | 70 |
| 2016 August | 37 | 6 | 43 |
| 2016 July | 26 | 6 | 32 |
| 2016 June | 0 | 4 | 4 |
| 2016 May | 0 | 6 | 6 |
| 2016 April | 2 | 2 | 4 |
| 2016 March | 0 | 2 | 2 |
| 2016 February | 0 | 10 | 10 |
| 2015 December | 7 | 0 | 7 |
| 2015 November | 0 | 9 | 9 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 2 | 0 | 2 |
| 2015 July | 15 | 4 | 19 |
| 2015 June | 26 | 10 | 36 |
| 2015 May | 27 | 3 | 30 |
| 2015 April | 22 | 7 | 29 |
| 2015 March | 15 | 4 | 19 |
| 2015 February | 11 | 6 | 17 |
| 2015 January | 12 | 11 | 23 |
| 2014 December | 22 | 11 | 33 |
| 2014 November | 17 | 9 | 26 |
| 2014 October | 15 | 7 | 22 |
| 2014 September | 13 | 9 | 22 |
| 2014 August | 20 | 11 | 31 |
| 2014 July | 23 | 13 | 36 |
| 2014 June | 38 | 9 | 47 |
| 2014 May | 44 | 10 | 54 |
| 2014 April | 25 | 11 | 36 |
| 2014 March | 33 | 16 | 49 |
| 2014 February | 23 | 10 | 33 |
| 2014 January | 23 | 9 | 32 |
| 2013 December | 25 | 6 | 31 |
| 2013 November | 10 | 7 | 17 |
| 2013 October | 34 | 11 | 45 |
| 2013 September | 29 | 15 | 44 |
| 2013 August | 24 | 5 | 29 |
| 2013 July | 23 | 5 | 28 |
| 2013 June | 27 | 10 | 37 |
| 2013 May | 18 | 6 | 24 |
| 2013 April | 15 | 6 | 21 |
| 2013 March | 15 | 5 | 20 |
| 2013 February | 17 | 5 | 22 |
| 2013 January | 7 | 6 | 13 |
| 2012 December | 16 | 1 | 17 |
| 2012 November | 12 | 5 | 17 |
| 2012 October | 5 | 6 | 11 |
| 2012 September | 6 | 3 | 9 |
| 2012 July | 1 | 0 | 1 |
| 2012 June | 3 | 0 | 3 |
| 2012 April | 5 | 0 | 5 |
| 2012 March | 1 | 0 | 1 |
| 2012 February | 4 | 0 | 4 |
| 2011 December | 9 | 0 | 9 |
| 2011 November | 7 | 0 | 7 |
| 2011 October | 4 | 0 | 4 |
| 2011 August | 1 | 0 | 1 |
| 2011 July | 5 | 0 | 5 |
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