Análisis de las interconsultas de pacientes nuevos recibidas en un policlínico de reumatología de un hospital terciario / Analysis of referrals of new patients to the rheumatology section of a tertiary hospital

RESUMO

Background: The prevalence of rheumatic diseases is approximately 15 percent in the general population. Aim: To assess the concordance between the original and final diagnosis of patients referred to a rheumatology unit. Patients and 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 percent females, aged 54.7ñ14 years old, were analyzed. Twenty seven percent of patients were referred with the diagnosis of connective tissue diseases, 26 percent with extra articular diseases and 24 percent 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