Rheumatic disorders in primary care. A study of two primary care centres and a review of previous Swedish reports on primary care.

Utilization of care for rheumatic disorders was studied in two primary care units. In both units 12% of visits concerned some form of rheumatic disease. This diagnostic group (chapter XIII of ICD) ranked third after cardiovascular and respiratory diseases. The total number of visits per inhabitant was higher for all diagnoses, as well as for the rheumatic disorders, in the most remote primary care unit. The distribution of rheumatic diagnoses was similar in the two units. Back disorders were most frequent among men, whereas soft tissue rheumatism and back disorders each accounted for one-third of the cases among women. Inflammatory rheumatic diseases and osteo-arthritis played only a minor part. Visits due to rheumatic disorders decreased after retirement age, particularly among men. The findings were representative of primary care in rural areas of Sweden. Only 20% of referrals from primary care to the rheumatology department gave a tentative diagnosis and half of these suggestions were changed after examination. The majority of referred patients without any suggested diagnosis suffered from soft tissue rheumatism or inflammatory rheumatic disorders other than rheumatoid arthritis.