A cross-sectional study of referrals to the ENT out-patients department in a Tertiary setting

Abstract

Background: South Africa is historically plagued with social inequality resulting in challenges accessing healthcare. Streamlining referral systems may aid in providing appropriate and timely healthcare to patients, improving their quality of life. Ear nose and throat (ENT) conditions can account for up to 50% of GP referrals. Chris Hani Baragwanath Hospital (CHBAH) ENT services a substantial portion of the Gauteng population.

Method: This was a single center prospective cross-sectional study at the ENT OPD at CHBAH conducted over 6 weeks. Informed consent was taken thereafter a data sheet used to record patient details, employment status, pathology, duration, and appropriateness of referral. Patients excluded were those with incomplete details and where consent was denied. The clinical and epidemiological profile of new patients attending ENT Out-patient department (OPD) was analyzed and compared to international trends.

Results: The cohort of 200 patients had a wide age range of 79.89 years and mean of 26.9 years and predominantly female. Most patients were unemployed. Majority of referrals were from general doctors at primary health care centers. There was an even distribution of urgent and non-urgent referrals, most being non-malignant. The majority of cases were appropriately referred. A foreign body in the ear was the commonest diagnosis with 23 cases (11.5.0%) followed by 15 cases (7.5%) of sensorineural hearing loss and 13 cases (6.5%) of recurrent tonsillitis.

Conclusion: Patients presenting to the ENT OPD at CHBAH were mostly female of lower socioeconomic status. The pathology seen is comparable with other upper- and lower-income countries.