Abstract
Background: The consultation patterns of an otolaryngology service have not previously been reported. The Emergency departments (ED) across the world are routinely overcrowded and will likely continue to remain so due to the patients' unwillingness to wait for outpatient visits. The time, resources, and attention required to operate such consultation services are unknown. Patients with diverse otorhinolaryngologic concerns often have conditions that can be appropriately triaged and medically managed by primary care professionals. The overwhelming number of ENT related ED visits has spawned the creation of otolaryngology-specific EDs to address this high demand for services. Consequently, most EDs continue to see a high volume of patients with ENT conditions, a large proportion of which do not need to be evaluated in the ED by an otolaryngologist-head and neck surgeon but may require outpatient follow-up.
However, recent database reviews demonstrate that individuals with poor access to health care services may be more likely to present to the emergency department (ED) for evaluation and treatment of routine conditions, Although the ED is designed to serve patients with urgent medical needs, it has become a convenient access point for many patients with non-urgent conditions, despite the extended wait times and potentially inferior clinical outcomes. Aim of the study: To identify the relationship between numbers of consultation each year sent to the otolaryngology department, age and location of each referring department in the facility. Method: Retrospective administrative database review at a tertiary referral hospital. Results: This is a Retrospective study of in-hospital referrals made to the department of Otolaryngology over three years and six months period in a tertiary referral hospital; the proportion of patients with consultations to an Otolaryngology department from 2015 to 2018 has increased significantly. Most cases were seen by junior members of staff and were of minor problems that could have been referred to a routine out-patient clinic. Our institute had a total number of 3539 patients with otolaryngology in hospital referrals from a variety of departments. The emergency department had a total of 1372 (38.8%) referrals, while internal medicine counted 518 (14.6%). Conclusion: There has been a significant increase in the volume of on-call otolaryngology consultations in our tertiary Institutions. Patients referred to the Otolaryngology department were of a varied clinical nature. Emergency department referrals were on the top of the list and then followed by internal medicine. This suggests the need for improvement in the Consultation criteria, as well as an improvement in the information provided. The need to identify changes in the volume of consultations in an inpatient setting, plus Emergency visits to set better access to care to urgent cases. Cost savings measures may be done by increasing health care access points for non-urgent concerns that can be evaluated in an outpatient setting.