Referrals for recurrent respiratory tract infections including otitis media in young children

(a) To establish whether disease-related, child-related, and physician-related factors are independently associated with specialist referral in young children with recurrent RTI, and (b) to evaluate whether general practitioners (GPs) follow current guidelines regarding these referrals. Electronic G...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology Vol. 77; no. 6; pp. 906 - 910
Main Authors: van de Pol, Alma C., van der Gugten, Anne C., van der Ent, Cornelis K., Schilder, Anne G.M., Benthem, Elsje M., Smit, Henriette A., Stellato, Rebecca K., de Wit, Niek J., Damoiseaux, Roger A.
Format: Journal Article
Language:English
Published: Ireland Elsevier Ireland Ltd 01.06.2013
Subjects:
Age Factors
Cohort Studies
Confidence Intervals
ear, nose, and throat (ENT, otorhinolaryngology)
Female
Guideline Adherence
Humans
Incidence
Infant
Infant, Newborn
Male
Multivariate Analysis
Otitis media
Otitis Media - diagnosis
Otitis Media - drug therapy
Otitis Media - epidemiology
Otolaryngology
Pediatrics
Practice Guidelines as Topic
Primary care
Prognosis
Recurrence
Referral and Consultation - statistics & numerical data
Respiratory diseases
Respiratory Tract Infections - diagnosis
Respiratory Tract Infections - drug therapy
Respiratory Tract Infections - epidemiology
Retrospective Studies
Risk Assessment
Severity of Illness Index
Pediatrics
Otitis media
ear, nose, and throat (ENT, otorhinolaryngology)
Primary care
Respiratory diseases
ISSN:0165-5876, 1872-8464, 1872-8464
Online Access:Get full text
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Summary:(a) To establish whether disease-related, child-related, and physician-related factors are independently associated with specialist referral in young children with recurrent RTI, and (b) to evaluate whether general practitioners (GPs) follow current guidelines regarding these referrals. Electronic GP records of children under 24month of age, born 2002–2008, were reviewed for RTI episodes using ICPC codes. Child-related factors were extracted from the prospective WHISTLER birth-cohort in which a considerable part of children had been enrolled. To evaluate guideline adherence, referral data were compared to national guideline recommendations. Consultations for 2532 RTI episodes (1041 children) were assessed. Seventy-eight children were referred for recurrent RTI (3.1% of RTI episodes; 7.5% of children). Disease factors were the main determinants of referral: number (OR 1.7 [CI 1.7–1.7]) and severity of previous RTI episodes (OR 2.2 [CI 1.6–2.8]), and duration of RTI episode (OR 1.7 [CI 1.7–1.8]). The non-disease factors daycare attendance (OR 1.3 [CI 1.0–1.7]) and 5–10 years working experience as a GP compared with <5 years (OR 0.37 [CI 0.27–0.50]) were also associated. Fifty-seven percent of referrals for recurrent RTI were made in accordance with national guidelines. Referral of children for recurrent RTI was primarily determined by frequency, severity, and duration of RTIs; the influence of non-disease factors was limited. Just over half of referrals were made in accordance with guidelines.
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ISSN:0165-5876
1872-8464
1872-8464
DOI:10.1016/j.ijporl.2013.03.003