Vestibular symptoms referred to otorhinolaryngologist for primary care in the city of Recife

Introduction: Primary Care is the user’s “gateway” to the Unified Health System: if the physician has difficulty conducting the case, they refer it to a specialist. Otorhinolaryngology is one of the specialties that receives referrals the most, with long waiting time in this setting. Objective: To e...

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Detalles Bibliográficos
Autores: Bunzen, Débora, Lima, Fabianne, Figueiredo, Maria Eduarda, Fontinele, Larissa
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:Brasil
Institución:Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
Repositorio:Revista Brasileira de Medicina de Família e Comunidade (Online)
Idioma:portugués
inglés
OAI Identifier:oai:ojs.rbmfc.org.br:article/2751
Acceso en línea:https://rbmfc.org.br/rbmfc/article/view/2751
Access Level:acceso abierto
Palabra clave:Dizziness
Vertigo
Referral and consultation
Primary health care
Waiting lists
Labyrinthitis.
Mareo
Vértigo
Derivación y consulta
Atención primaria de salud
Listas de espera
Laberintitis.
Tontura
Vertigem
Encaminhamento e consulta
Atenção primária à saúde
Labirintite.
Descripción
Sumario:Introduction: Primary Care is the user’s “gateway” to the Unified Health System: if the physician has difficulty conducting the case, they refer it to a specialist. Otorhinolaryngology is one of the specialties that receives referrals the most, with long waiting time in this setting. Objective: To estimate the frequency of complaints of dizziness and suspected vestibular disease in referrals of patients awaiting consultation with an otorhinolaryngologist. There are few studies addressing this topic in the literature, and this survey is important because it helps design the profile of these patients and plan public health actions. Methods: Observational, longitudinal, descriptive study based on collection of secondary data from the Regulatory System of the Health Department of the City of Recife. Requests from Family Health Strategy (FHS) physicians for the Otorhinolaryngology service in October-November 2019 were included, and those who had been on the waiting list since June-July 2018. Results: The frequency of referrals for dizziness and suspected vestibular disease was 22.5% of all requests for Otorhinolaryngology. The waiting time was one year and four months. most patients were women (74.7%) and aged over 60 years (48.3%). The reasons for referrals were: tinnitus (43.2%), labyrinthitis (20%), multiple symptoms (17.3%), dizziness (11.6%), vertigo (3.9%), labyrinthopathy (3.6%), and benign paroxysmal positional vertigo (0.6%). Symptoms increase with age. Conclusions: The referral rate was compatible with the literature. Tinnitus is a very uncomfortable symptom, common in labyrinthine diseases and other pathologies, so the high frequency of solicitation. The term labyrinthitis does not always refer to vestibular neuronitis, but it can erroneously be used for any vertiginous syndrome, which may justify a high referral rate to the detriment of other vestibular pathologies. Continuing education in Primary Care is important for both the correct diagnosis and the appropriate request for interconsultation. New strategies to reduce waiting times are needed such as increasing the supply of specialist services, demanding qualification, and optimizing the regulatory system.