Results
Two hundred and fifty-nine patients were included in this study, with a
median age of 19.4 years (0.9-91.3 years). The median distance patients
resided from <blinded for review> was 15 km
(9-179 km) and 2 patients required a telephone interpreter. Details of
patient demographics, condition referred, and treatment outcome are
presented in Table 1.
The median duration between the date of the first referral and the date
of the first telephone appointment with the date of the definitive
physical appointment were 317 days (9-1018 days) and 35 days (1-201
days), respectively.
The most common conditions referred to the OHNS clinic were for
consideration of tonsillectomy with or without adenoidectomy (44.0%),
with the majority of patients undergoing surgical treatment (69.5%).
The median number of telephone and physical consultations per patient
were 1 (1-3) and 1 (1-2), respectively.
Overall diagnostic accuracy of the initial referrer was 63.3%, with the
accuracy of their examination findings being 33.6%. In 58.7% of
referrals, examination findings were not stated. The diagnostic accuracy
of telephone consultations was 81.9%, with the concordance of
recommended treatment plans between telephone and physical consultations
being 96.9%.
Residing less than 50km from the hospital, not having concurrent medical
conditions and referrals for consideration of tonsillectomy with or
without adenoidectomy were associated with significantly better referrer
and telephone appointment diagnostic rates (Table 2). Paediatric
patients had significantly higher telephone appointment diagnostic rates
as well as concordance of recommended treatment plans. Referrals for
consideration of grommets, laryngology and otology conditions were
associated with significantly poorer referrer and telephone appointment
diagnostic rates. More accurate referrer examination findings were
observed in paediatric patients, referral for head and neck cancer, and
less accurate for laryngology and rhinology conditions.