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耳鸣患者比没有耳鸣的人更多地使用初级保健。

Patients with tinnitus use more primary healthcare compared to people without tinnitus.

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

出版信息

Sci Rep. 2021 Aug 27;11(1):17299. doi: 10.1038/s41598-021-96607-x.

Abstract

Tinnitus is a heterogeneous condition not only in terms of nature of the sound, but also in co-morbidities such as mental health issues. Prevalence number range widely between 5 and 43%. Even though the etiologic pathway between tinnitus and its comorbidities remains unclear, in this study we aim to assess whether people with tinnitus use more primary health care than people without tinnitus. To compare primary healthcare consumption between patients with tinnitus and people without tinnitus. In this cross-sectional study, data on number of consultations with the general practitioner or nurse practitioner mental health services were obtained from Nivel (Netherlands Institute for Health Service Research) Primary Care Database in 2018 (n = 963,880 people). People with an open tinnitus episode (n = 8050) were defined as a patient with tinnitus and compared to all other people. Percentages, means, ranges and mean differences were calculated for the total number of consultations and for organ specific diagnoses registered as ICPC-1 code on the day of consultation. Secondary, the total number of referrals to medical specialists and number of drug prescriptions was collected. Logistic regressions were performed to predict having one or more contacts, referrals, and prescriptions,with having tinnitus, this was corrected for age and gender. Patients with tinnitus had a mean of 9.8 (SD 10.9) primary care consultations in 2018, compared to 5.7 (SD 7.9) for people without tinnitus. More patients with tinnitus had more than one referral to medical specialists (47%) compared to people without tinnitus (25%). Patients with tinnitus have 1.2 (mean difference) more drug prescriptions than people without tinnitus. Compared to people without tinnitus, patients with tinnitus were more likely to have one or more of primary healthcare contact, independent of age group and gender. Patients with tinnitus had more consultations in primary health care than people without tinnitus. They are more often referred to medical specialists and receive more drug prescriptions. The causal relationship between tinnitus and the higher healthcare consumption remains to be researched.

摘要

耳鸣不仅在声音性质上存在异质性,而且在心理健康等共病方面也存在异质性。发病率的范围在 5%到 43%之间。尽管耳鸣及其共病的病因途径仍不清楚,但在这项研究中,我们旨在评估耳鸣患者是否比无耳鸣患者使用更多的初级保健。评估耳鸣患者与无耳鸣患者之间的初级保健消费。在这项横断面研究中,我们从 2018 年 Nivel(荷兰卫生服务研究协会)初级保健数据库中获取了与全科医生或护士从业者精神卫生服务的咨询次数的数据(n=963880 人)。有开放耳鸣发作的人(n=8050 人)被定义为耳鸣患者,并与所有其他人进行比较。计算了总咨询次数和当天咨询时作为 ICPC-1 代码登记的器官特异性诊断的百分比、平均值、范围和平均值差异。其次,收集了转诊给医学专家的总人数和开具的药物处方数。进行逻辑回归以预测有一个或多个接触、转诊和处方,患有耳鸣,这是根据年龄和性别进行校正的。与无耳鸣者相比,耳鸣患者在 2018 年的平均初级保健咨询次数为 9.8(SD 10.9),而无耳鸣者为 5.7(SD 7.9)。与无耳鸣者相比,更多的耳鸣患者有超过一次的转诊给医学专家(47%)。与无耳鸣者相比,耳鸣患者的药物处方多 1.2(平均差异)。与无耳鸣者相比,耳鸣患者更有可能进行一次或多次初级保健接触,与年龄组和性别无关。耳鸣患者在初级保健中就诊次数多于无耳鸣者。他们更常被转诊给医学专家,并接受更多的药物处方。耳鸣与更高的医疗保健消费之间的因果关系仍有待研究。

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