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The care pathway of individuals with spinal disorders in a Health Care Network in the Federal District, Brazil: a retrospective study

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ASSOCIACAO BRASILEIRA PESQUISA POS-GRADUACAO FISIOTERAPIA-ABRAPG-FT
DOI: 10.1016/j.bjpt.2023.100553

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Low back pain; Physical therapy; Primary health care; Spinal disease; Uni fied health system

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This study investigated the care pathway and interventions for individuals with non-specific spinal disorders in the Federal District of Brazil. The results showed that the emergency department was the most commonly accessed setting, with a majority of individuals undergoing imaging tests and receiving drug prescriptions. However, few participants received exercise prescriptions and only half were referred to physical therapists. Women were more likely to first access the emergency department, and increasing age was associated with a greater chance of first accessing outpatient clinics.
Background: Understanding the care pathway is essential to identify how to effectively treat spinal disorders. However, there is no specific data on the pathway of these individuals in the Objective: To investigate the pathway of individuals with non-specific spinal disorders (NSD) in the HCN in the Federal District, Brazil, and verify the interventions adopted, and to test whether sociodemographic and clinical variables predict the number of imaging tests, prescribed medication, and the first HCN access.Methods: Retrospective study that analysed electronic records of 327 individuals with NSD between 2012 and 2018. Generalized linear models estimated the association between sociodemographic and clinical data and number of drugs prescribed and imaging tests requested. Multinomial logistic regression estimated the association between clinical and demographic variables and setting of first access.Results: The median age was 57 years, and 75.5% were women. Emergency Department (ED) was the most accessed setting (43.7%), and back pain was the most prevalent condition (84.5%). Most individuals underwent imaging tests (60%) and drug prescriptions (86%). Physical exercises were prescribed to 13%, and 55% were referred to physical therapy. Women were more likely to first access the ED.Conclusion: The ED was the most used setting by people with NSD. Few participants received exercise prescriptions and half were referred to physical therapists. Individuals who used outpatient clinics and primary care received less drug prescriptions, and women were more likely to first access the ED. Increasing age was associated with greater chance of first accessing Outpa-tient Clinics. (c) 2023 Associa & ccedil;& atilde;o Brasileira de Pesquisa e P & oacute;s-Gradua & ccedil;& atilde;o em Fisioterapia. Published by Elsevier Espa & ntilde;a, S.L.U. All rights reserved.

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