Management of patients at primary care who admit to a Otorhinolaryngology Head and Neck Surgery department outpatient clinic

Abstract

Aim: Majority of the health problems that family physicians encounter are associated with otorhinolaryngology (ORL) diseases. It was aimed in this study to determine how many of the patients who admitted to ORL out-patients clinics at a training and research hospital can be managed by primary care physicians, the attitudes of patients about this issue and their thoughts about family medicine practice.

Materials and Methods: A total of 300 patients who were attended to Keçiören Training and Research Hospital Otorhinolaryngology - Head and Neck Surgery out patient clinics between AprilMay 2016, were included into the study and sociodemographic and clinic characteristics, compliants of referrral, family physician visits for the same complaints, frequency of visits to family physicians and satisfaction status of patients using primary care, diagnosis after the examination of ORL specialist were recorded.

Results: Mean age of patients was 49,04±16,17 years, 64% of them were female, 36% were male. Most common admission complaints were sore throat (%24.1), otalgia (%13.3), voice in the ear (13,0%), hear loss (12,3%) and nasal/postnasal drainage (10,3%); most common diagnoses were impact serumen (16,7%), acute pharyngitis (10,0%), tinnitus (8,3%), benign paroxysmal vertigo (7,7%) and acute otitis media (7,02%), respectively. Of all the patients 70,7% reported that they did not visit their family physicians for these complaints. Of the patients 18% were admitted ORL outpatient clinics with the referral of family physicians, One hundred eighty-seven patients (62,3%) reported that they have never visited their family doctors. Admission rates to primary care were higher in married patients than those single (p<0.05). Satisfaction rates were high in patients who admitted to family physicians (p<0.05).

Conclusions: Our findings suggested that %70 of diagnoses of patients admitted to ORL out-patient clinics can be managed in primary care. For the correct use of secondary and tertiary health care facilities, a working referral system, qualified family physicians and sufficient public consciousness are essential.