SciELO - Scientific Electronic Library Online

 
vol.41 issue5Breast feeding determinants on the first year of life of children in a city of Midwestern BrazilPrevalence of speech disorders in schoolchildren and its associated factors author indexsubject indexarticles search
Home Page  

Revista de Saúde Pública

Print version ISSN 0034-8910

Abstract

GUERRA, Angela Francisca Marques et al. Pediatric (Otolaryngology) at the Public Health System of a city in Southeastern Brazil. Rev. Saúde Pública [online]. 2007, vol.41, n.5, pp. 719-725. ISSN 0034-8910.  http://dx.doi.org/10.1590/S0034-89102007000500005.

OBJECTIVE: To assess the suitability of referral from primary to secondary care in pediatric Otolaryngology. METHODS: The study was performed in the city of Belo Horizonte, in the state of Minas Gerais, from March 2004 to May 2005. A total of 408 pre-school children referred from primary care to secondary care in the department of Otolaryngology presenting with otitis, tonsillitis, sinusitis, allergic rhinitis, and tonsillar/adenoidal hypertrophy was assessed. The studied variables were: agreement between diagnoses in primary and secondary care; waiting time for doctor's appointment; follow-up, and professional (pediatrician or family physician) that examined children in primary care. Agreement of diagnoses was assessed using kappa statistics. RESULTS: Patients were five years old on average, 214 (52.5%) were boys, mean waiting time for appointment was 3.7 months. Diagnoses in primary and secondary care were respectively: otitis (44%, 49%), tonsillar/adenoidal hypertrophy (22%, 33%), tonsillitis (18%, 23%), sinusitis (13%, 21%), allergic rhinitis (3%, 33%). Agreement analysis of kappa was 0.15 for otitis with effusion, 0.35 for recurrent otitis, 0.04 for tonsillar/adenoidal hypertrophy, 0.43 for tonsillitis, 0.05 for allergic rhinitis, and 0.2 for sinusitis. Diagnoses in primary care referred to secondary care were in agreement when given either by pediatrician or family physician. CONCLUSIONS: Unsuitability of referrals from primary to secondary care in otolaryngology was expressed by the long time waiting for appointments and by the low agreement between diagnoses in different level of care for the same patients. Primary health care could be more efficient if professionals were better qualified in Otolaryngology.

Keywords : Otorhinolaryngologic diseases [epidemiology]; Otorhinolaryngologic diseases [prevention & control]; Primary health care; Secondary health care; Health care [Public Health]; Health services; Preschool child.

        · abstract in Portuguese     · text in English | Portuguese     · pdf in English | Portuguese