Role of general practitioner, specialist and insurance practitioner in managing knee impairment
Abstract
Background: Proper treatment of the pacient with knee injury or disease, early diagnosis, therapy, rehabilitation which may include use of knee orthoses are most important for the best outcome. Communication between general practitioner, the specialists involved and even insurance practitioner on ZZZS (Health Insurance Institute of Slovenia) and especially motivation of the patient are essential for the best cure in every case. World-wide studies showed opposite, positive and negative effects of active support of knee orthoses. The aim of the study was to find out if any differences could be detected in deciding about confirmation of knee orthoses and health resort rehabilitation between insurance practitioners in Slovenia.
Methods: Retrospective review of number of confirmed orthoses and especially knee orthoses in connection with registrated active population of ten ZZZS areas on the ZZZS division for orthoses in 2001, 2002 in 2003 has been done. Retrospective review of number of all confirmed health resort rehabilitation and comparison for selected ten diagnosis of knee injuries and diseases in connection with registered active population of ten ZZZS areas from ZZZS computer basis data in 2001, 2002, 2003 in 2004 has been done.
Results: Analysed data indicated a decrease in number of confirmed knee orthoses and number of health resort rehabilitation but moderate increase in number of health resort rehabilitation for selected ten diagnosis. Top number of confirmed orthoses in connection with registered active population was detected in Novo mesto and Maribor ZZZS area and the smallest number in Koper and Nova Gorica ZZZS area. Top number of health resort rehabilitation for selected ten diagnosis of knee dysfunction was confirmed in Krško and Ravne na Koroškem ZZZS area and the smallest number in Maribor and Koper ZZZS area.
Conclusions: The research showed differences between decisions of insurance practitioners about knee orthoses and health resort rehabilitation in Slovenia. ZZZS strategy of controling costs means strict control of costs for medical devices and health resort rehabilitations. In view of popularisation of sport activities and eldering population there are much more knee injuries and diseases. That means increase in knee orthoses and health resort rehabilitation. We need best adjusted professional criteria of all involved specialists and out of them reliable criteria for best decisions of insurance practitioners on ZZZS to assure equal treatment of the patients all over Slovenia.
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