Starmer Heather M, Liu Zaneta, Akst Lee M, Gourin Christine
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Ann Otol Rhinol Laryngol. 2014 Feb;123(2):117-23. doi: 10.1177/0003489414523708.
We sought to determine the effect of referral patterns on attendance in voice therapy.
Patients who were seen by a laryngologist for vocal concerns and referred for voice therapy comprised the study population. Outcomes were compared between those who were initially evaluated through the interdisciplinary voice clinic (IDC), which combined speech-language pathology and laryngology care, and those who were evaluated by a laryngologist alone. Adherence was measured by completion of the plan of care.
There were 79 patients evaluated through the IDC and 100 patients evaluated initially by a laryngologist. Patients evaluated through the IDC had more visits with the speech-language pathologist (mean, 3.1 versus 1.24; p < 0.0001). Those initially evaluated through the IDC were more likely to complete their plan of care (p = 0.02). Completion of voice therapy was significantly more likely for individuals coded as being of "other" race (odds ratio, 7.98; p = 0.002) and for patients who participated in the IDC (odds ratio, 2.56; p = 0.018). The cause of dysphonia, sex, marital status, insurance status, days from laryngology referral to the initial speech-language pathologist consultation, the initial Voice-Related Quality of Life score, and distance to the clinic were not associated with patient attendance.
Patients evaluated in a coordinated IDC should be more likely to attend voice therapy and complete their plan of care, regardless of other factors.
我们试图确定转诊模式对嗓音治疗就诊率的影响。
因嗓音问题由喉科医生诊治并被转诊至嗓音治疗的患者构成了研究人群。对那些最初通过跨学科嗓音诊所(IDC)进行评估的患者(该诊所结合了言语病理学和喉科学护理)与那些仅由喉科医生评估的患者的结果进行比较。通过护理计划的完成情况来衡量依从性。
通过IDC评估的患者有79例,最初由喉科医生评估的患者有100例。通过IDC评估的患者与言语病理学家的就诊次数更多(平均次数分别为3.1次和1.24次;p<0.0001)。那些最初通过IDC评估的患者更有可能完成他们的护理计划(p = 0.02)。被编码为“其他”种族的个体(优势比为7.98;p = 0.002)以及参与IDC的患者(优势比为2.56;p = 0.018)完成嗓音治疗的可能性显著更高。发声障碍的原因、性别、婚姻状况、保险状况、从喉科转诊到最初言语病理学家会诊的天数、最初的嗓音相关生活质量评分以及到诊所的距离与患者就诊率无关。
无论其他因素如何,在协调的IDC中接受评估的患者应该更有可能参加嗓音治疗并完成他们的护理计划。