2016 年 30 巻 3 号 p. 280-286
Objective : According to a recent nationwide survey, spinal surgeries performed by neurosurge-ons account for about 17% of all neurosurgical operative procedures in Japan.
Although this proportion is gradually increasing, it is lower compared with the value reported for European and American neurosurgery, which is about 70%. To expand the territory of Japanese neurosurgeons, the percentage of neurosurgical operative procedures must be raised up to the European and American level. One of the methods to achieve this objective is the meticulous accumulation and detailed analysis of the visiting behavior of patients with spinal disorders to hospital or clinic.
In the present study, we investigated the visiting behavior of patients with degenerative spinal diso-rders.
Materials and Methods : Between Jan 2015 and Dec 2015, 337 patients were operated at our hospital for degenerative spinal disorders. In the present study, responses to the following questionnaires were meticulously collected by the attending doctor.
The questionnaires were as follows :
1. The name and kind of the clinical department of the patient’s first visit.
2. The reasons for their choice of their first consulting department.
3. Information about the other hospitals or clinics they visited before coming to our hospital.
4. The reasons for their choice of our hospital.
Results : In 233 patients with lumbar degenerative disorders, 146 patients (63%) chose orthopedics as the first visiting clinic. Nineteen percent of the patients selected neurosurgeons and 6% chose bone setters. In 104 patients with cervical degenerative disorders, 49 patients (47%) chose orthopedics as the first visiting clinic, 20% visited a neurosurgeon first, and 13% were treated at the emergency department.
Regarding the reason why patients chose our hospital, 63% of the patients were referred to our hospital due to the introduction by their referral doctor (Orthopedics accounted for 60% of these referral doctors, neurosurgeons 15%, and pain clinic doctors 14.7%).
Conclusions : Although the accumulation of data was meticulously performed, the present study was conducted at a single and specific hospital. The analysis of the limited data samples cannot bring satisfactory suggestions for Japanese neurological surgery. To analyze patients’ visiting behaviors correctly, a nationwide clinical survey must be performed. The authors suggest conducting a similar survey at other hospitals and universities in Japan. By collecting large quantities data about such patients’ visiting behaviors and meticulous analysis of such data, the next advanced strategy can be produced to widen the horizons of Japanese neurosurgeons.
