Re-referrals to a Danish regional spine centre.

INTRODUCTION

In Denmark, general practitioners are the primary providers, referring patients to specialised spine care. Re-referral may indicate unresolved spinal pain, but can also reflect inefficiencies in patient management. This study determined the rate of re-referrals to a Danish regional spine centre within 500 days of the initial visit and identified patient-specific factors associated with re-referrals.

METHODS

A cohort study of patients at the Spine Centre of Southern Denmark was conducted from January 2019 to December 2023. Re-referrals were defined as visits between 50 and 500 days after the initial consultation. Factors investigated included referral diagnoses, patient-reported outcomes and clinical services initiated. Multivariable logistic regression identified associations with re-referral.

RESULTS

Among 30,872 patients, re-referrals were observed in 10.3% (n = 3,095). Previous back surgery (OR = 1.23), pain medication (OR = 1.37), MRI referrals (OR = 1.6), provision of rehabilitation plans (OR = 1.26), extremity pain (OR = 1.02) and loneliness (OR = 1.02) were associated with increased odds of re-referrals. In contrast, non-specific spinal pain diagnosis reduced the likelihood (OR = 0.83). Model discrimination was limited (Tjur's coefficient of discrimination (D) = 0.017), indicating weak predictive performance.

CONCLUSIONS

Re-referrals were common. Certain clinical factors were associated with re-referrals to a spine centre. Still, their predictive value was limited, making it difficult to recommend strategies to reduce re-referrals from general practice.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.