Quinlan Brian P, Tan Wilhelmina, Coblens Orly, McKinnon Brian
Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, Galveston, USA.
Cureus. 2024 Sep 25;16(9):e70155. doi: 10.7759/cureus.70155. eCollection 2024 Sep.
Purpose Compared to insured individuals who have established pathways for primary and specialist care, uninsured patients often delay seeking medical attention and are more likely to rely on emergency departments or community clinics for low-cost services. This study aims to identify the most prevalent otolaryngology (ENT) diagnoses at a free, student-run community clinic for uninsured patients. Additionally, it seeks to elucidate their management needs in order to inform strategies for enhancing support and care for this vulnerable population. Methods The electronic medical records for a free, student-run community clinic (St. Vincent's Hope Student Clinic in Galveston, Texas) were reviewed. Patient age, sex, chief complaint, date of medical encounter, and encounter diagnoses from April 2021 to May 2024 were recorded; medical diagnoses were then manually stratified into system categories and diagnostic subgroups. Diagnoses unrelated to ENT were excluded and likely represented secondary encounter diagnoses. Results A total of 38 patients were evaluated across 51 total ENT encounters. The average number of encounters per patient per year was 1.34 (1.05-1.63, 95% CI). The most common ENT category was throat (37%), and the most common individual diagnosis was balance problems (11% of total diagnoses). Conclusion The most common ENT system was the throat, followed by ear, nose, and other. Balance problems, reflux, and allergic rhinitis were the most common individual ENT diagnoses. The analysis of data collected for this study may help direct future care and resource allocation at this clinic.
目的 与那些已建立初级和专科护理途径的参保个体相比，未参保患者往往会延迟就医，并且更有可能依赖急诊科或社区诊所来获取低成本服务。本研究旨在确定一家由学生运营的免费社区诊所中未参保患者最常见的耳鼻喉科（ENT）诊断。此外，研究试图阐明他们的管理需求，以便为加强对这一弱势群体的支持和护理的策略提供信息。方法 对一家由学生运营的免费社区诊所（德克萨斯州加尔维斯顿的圣文森特希望学生诊所）的电子病历进行了回顾。记录了2021年4月至2024年5月期间患者的年龄、性别、主要诉求、就诊日期和就诊诊断；然后将医学诊断手动分层到系统类别和诊断亚组中。排除与耳鼻喉科无关的诊断，这些诊断可能代表二次就诊诊断。结果 总共对38名患者进行了51次耳鼻喉科就诊评估。每位患者每年的平均就诊次数为1.34次（1.05 - 1.63，95%置信区间）。最常见的耳鼻喉科类别是咽喉（37%），最常见的个体诊断是平衡问题（占总诊断的11%）。结论 最常见的耳鼻喉科系统是咽喉，其次是耳、鼻和其他部位。平衡问题、反流和过敏性鼻炎是最常见的个体耳鼻喉科诊断。对本研究收集的数据进行分析可能有助于指导该诊所未来的护理和资源分配。
