Villa Alessandro, Stock Shannon, Aboalela Ali, Lerman Mark A, Woo Sook-Bin, Sonis Stephen T, Treister Nathaniel S
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Department of Mathematics and Computer Science, College of the Holy Cross, Worcester, Massachusetts, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Apr;119(4):423-9. doi: 10.1016/j.oooo.2015.01.003. Epub 2015 Jan 20.
The objective of this study was to characterize the outpatient oral medicine (OM) clinic at Brigham and Women's Hospital (BWH), with particular emphasis on patient demographic characteristics and referral patterns.
A retrospective case record review of all initial consultations with OM experts at BWH from 2008 to 2010 was conducted. Data included demographic information, type of medical insurance, reason for referral, referring doctor's specialty, and distance between the patient's home and the referring doctor as well as BWH, number of prior doctors seen for the presenting problem (per patient report), tests ordered at the consultation visit, and clinical diagnoses.
There were 1043 new outpatient consultation visits. Patients lived a median distance of 9.5 miles from the referring doctor and 18.9 miles from BWH and saw a median of one doctor (range 0-9) before consultation. Two thirds of patients were referred by physicians. The most common diagnoses included immune-mediated mucosal conditions (27.2%), orofacial pain disorders (25.1%), benign tumors or neoplasms (10.3%), and dysplasia and cancerous conditions (7.6%). Biopsy was the most frequent test performed at consultation.
Patients with oral conditions often see more than one doctor, before being referred to an OM expert and typically travel twice the distance to the expert compared with that between their home and the referring doctor. Equal efforts should be made to increase awareness of the importance of the specialty of OM among dentists, physicians, and the public.
本研究旨在描述布莱根妇女医院（BWH）门诊口腔医学（OM）诊所的情况，特别关注患者的人口统计学特征和转诊模式。
对2008年至2010年期间在BWH向OM专家进行的所有初次会诊进行回顾性病例记录审查。数据包括人口统计学信息、医疗保险类型、转诊原因、转诊医生的专业、患者家庭与转诊医生以及BWH之间的距离、因当前问题之前看过的医生数量（根据患者报告）、会诊时所做的检查以及临床诊断。
共有1043次新的门诊会诊。患者居住的地方距离转诊医生的中位距离为9.5英里，距离BWH为18.9英里，会诊前看过的医生中位数量为1名（范围为0 - 9名）。三分之二的患者由医生转诊。最常见的诊断包括免疫介导的黏膜疾病（27.2%）、口面部疼痛障碍（25.1%）、良性肿瘤或赘生物（10.3%）以及发育异常和癌性疾病（7.6%）。活检是会诊时最常进行的检查。
患有口腔疾病的患者在被转诊至OM专家之前通常看过不止一名医生，而且与他们的家到转诊医生的距离相比，到专家处就诊的距离通常是两倍。应同样努力提高牙医、医生和公众对OM专科重要性的认识。
