広島大学緑内障外来における病診連携の問題点

Problems of cooperation between university hospital and regional eye clinics in the treatment of glaucoma

　緑内障診療における病診連携の現状と問題点を明らかにする目的で，広島大学緑内障外来とその関連地域の患者と紹介医にアンケート調査を行った。その結果，紹介元に戻っていない患者の存在が問題点としてあげられた。患者還元を妨げている要因として，手術後の患者が多いことに加え，大学病院に最新の医療技術を期待する患者の大病院志向があることがわかった。診療所での治療が困難な緑内障の症例が多数紹介されていることから，大学病院は，高度な手術治療を行う高次医療機関としての役割を期待されていると考えられた。診療所から診療情報の提供を望む意見が多く，病診連携の上で重要な情報交換に，なお多くの問題点が存在することがわかった。

We investigated the current status of cooperation and problems between our university hospital and regional eye clinics regarding treatment of glaucoma. Questionnaires were sent to glaucoma patients treated by us and to ophathalmologists in clinical practice in our district. As a major finding, patients referred to us often failed to reconsult the doctors who referred them. This was because many of the referral patients who underwent glaucoma surgery preferred to be followed up by the surgeon. As another reason, the majority of patients preferred the university hospital because they expected to receive more adequate treatment from the latter. These findings led us to conclude that patients be explicitly requested to report to the previous doctor. Also, ophthalmologists in clinical practice hoped to receive more detailed informa-tions about the patients referred from them to the university hospital. Further efforts for information exchange seemed to be necessary to achieve better cooperation between the hospital and the clinics.