Features in registration of knee osteoarthritis across primary care institutions in Arkhangelsk

Abstract

The aim of the research. To carry out a comparative analysis of registration of primary and overall incidence of gonarthritis (GA) and the factors affecting these indices in clinics of Arkhangelsk. Material and methods. Th e population of Arkhangelsk is attached to fi ve main polyclinics: No. 1, 2, 4 (AGKP1, AGKP2, AGKP4), the first city clinical hospital named aft er E. E. Volosevich (PGKB1) and the Primorsky Central district hospital (PPRCRB) together serving 74.7 % of the population. We formed a continuous sample based on the medical service utilisation rate in the attached population for gonarthritis patients within the period from 2016 to 2019. Th e analysed parameters were: gender, age, acute or chronic form of the disease, diagnosis according to ICD-10 and the specialist visited by the patient. The features in registration of GA at the level of primary healthcare institutions and their effect on primary and overall incidence were analysed. Results. In four years, a total of 3,282 of primary GA patients were registered in the fi ve clinics, the mean age was 55.9 years, female patients accounted to 1,952 (59 %), male patients – to 1,329 (41 %). The average annual levels of primary GA incidence per 1000 population ranged from 0.98 to 1.38, with the maximum of 3.05 registered in PGCB1. The overall incidence of GA per 1000 population in polyclinics 1, 2 and 4 was 26.2-27.4, with the values of 15.6 and 4.5 for PGKB 1 and PPRCRB, respectively. Patients over 60 years of age predominated in PGKB1 (48 %), amounting to 41 % in AGKP1, 27 % in AGKP2, 33 % in AGKP4, 32 % in PPRCRB. Maximal prevalence was 105 cases per 1000 population (1 % of the attached population) by 45 years in AGCP1, in other polyclinics the indicator was lower. More oft en, GA was diagnosed by general practitioners – 2296 (71 %), traumatologists and surgeons – 647 (20 %), rheumatologists – 302 (9 %). Th e most common diagnoses were M17.9-966 (30 %), M17.0 10 939 (29 %), less oft en: M17.2 – 66 (2 %) and M17.4 – 75 (2 %). Conclusion. Th ere is no unifi ed system of primary and general morbidity registration at the level of primary healthcare institutions within the same region. To objectify GA registration, it is necessary to introduce a single registry of patients.