Prevalence of Otolaryngology Refferal from Primary Health Care in Al-hasa Saudi Arabia

Abstract

Background: Primary healthcare (PHC) is prioritized in the Kingdom of Saudi Arabia's health reforms, with ENT services playing a vital role due to the high prevalence of ENT-related complaints, particularly in children. While most patients are successfully managed by primary care physicians, complex cases beyond their expertise are referred to specialists, making ENT complaints the third-largest group of patients referred to hospital specialist clinics. However, resource limitations, a shortage of qualified specialists, and patient requests for alternative services sometimes result in the need for further management that some hospitals are unable to provide, leading to costly and time-consuming transfers to other facilities. In the pediatric emergency department, ENT complaints are common, and paediatricians frequently consult otolaryngology specialists for various conditions such as foreign bodies, infections, trauma, and congenital issues.

Objectives: To assess the prevalence of referrals to ENT clinics in King Abdulaziz Hospital, Alhasa.

Method: A retrospective descriptive study took place.  A total of 269 referred patients from different age groups were included. After the data were extracted from the referral system at King Abdulaziz Hospital in 2022, they were revised, coded, and then fed to the statistical software IBM SPSS version 22. 

Result: A total of 269 referred patients were included. The most reported chronic health problems of referred patients from PHC to ENT clinics in King Abdulaziz Hospital are DLP (11.2%), HTN (10.4%), and DM (9.3%), respectively. However, most of the referred patients (70.6%) had no chronic health problems. The most common symptoms in family medicine clinics among the study population were hearing loss, snoring and mouth breathing, recurrent tonsillitis, impacted wax, recurrent epistaxis, and tinnitus. The vast majority of study patients (98.5%) had regular referrals, while only (1.5%) needed urgent referrals. Urgent referral was needed for 5.5% of patients under 10 years, comparable with older participants with statistical significance.

Conclusion: There is a high prevalence of regular referrals to ENT clinics in King Abdulaziz Hospital by 2022. Patient age was the only significant factor associated with the type of referral. It would be beneficial to evaluate patient preferences and clinical outcomes in future research.