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Int J Pediatr Otorhinolaryngol. 2013 Jun;77(6):906-10. doi: 10.1016/j.ijporl.2013.03.003. Epub 2013 Apr 6.

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

Author information

1
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.

Abstract

OBJECTIVE:

(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.

METHODS:

Electronic GP records of children under 24 month 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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID:
23566424
DOI:
10.1016/j.ijporl.2013.03.003
[Indexed for MEDLINE]

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