Ishikawa K, Tamagawa Y, Abe K, Kitamura K, Okuno M, Mizorogi N
Department of Otolaryngology, Jichi Medical School, Tochigi.
Nihon Jibiinkoka Gakkai Kaiho. 1996 Dec;99(12):1758-63. doi: 10.3950/jibiinkoka.99.1758.
In the present study, a survey of otorhinolaryngological medical care by the general practitioner, including the relationship between general practitioners and otorhinolaryngologists in rural areas was carried out. A questionnaire for otorhinolaryngological medical care by the general practitioners was sent to 326 hospitals with less than 100 beds where non-otorhinolaryngological doctors who had graduated from Jichi Medical School were working. Of these hospitals 164 (50.4%) responded. Most respondents said that they had about 3 or 4 patients with otorhinolaryngological disease per month. The distance between most hospitals and the nearest otorhinolaryngologists was within one hour by available transportation facilities. About 70% of the respondents were provided with simple otorhinolaryngological instruments, such as an aural speculum, a nasal speculum and a head mirror. The most frequent otorhinolaryngological diseases which they treated were vertigo, allergic rhinitis and upper respiratory infection including acute tonsillitis and pharyngolaryngitis. Only 10 to 20% of the general practitioners had otorhinolaryngological training. We found several problems in otorhinolaryngological medical care in rural areas. Patients with otorhinolaryngological disease seek otorhinolaryngological care at the nearest medical facility where general practitioners with inadequate otorhinolaryngological experience examine patients with inadequate otorhinolaryngological instruments. Therefore, a close relationship between general practitioners and otorhinolaryngologists should be developed and the quality of otorhinolaryngological medical care should be raised in rural areas.
在本研究中，开展了一项关于全科医生提供耳鼻咽喉科医疗服务的调查，包括农村地区全科医生与耳鼻咽喉科医生之间的关系。向326家床位少于100张、有毕业于自治医科大学的非耳鼻咽喉科医生工作的医院发放了关于全科医生耳鼻咽喉科医疗服务的调查问卷。其中164家医院（50.4%）做出了回应。大多数受访者表示，他们每月约有3或4名耳鼻咽喉科疾病患者。大多数医院与最近的耳鼻咽喉科医生之间的距离，乘坐现有的交通设施在一小时之内。约70%的受访者配备了简单的耳鼻咽喉科器械，如耳镜、鼻镜和头灯。他们治疗的最常见的耳鼻咽喉科疾病是眩晕、过敏性鼻炎以及包括急性扁桃体炎和咽喉炎症在内的上呼吸道感染。只有10%至20%的全科医生接受过耳鼻咽喉科培训。我们发现农村地区的耳鼻咽喉科医疗服务存在若干问题。患有耳鼻咽喉科疾病的患者会在最近的医疗机构寻求治疗，而那里的全科医生缺乏足够的耳鼻咽喉科经验，使用的耳鼻咽喉科器械也不足。因此，应在农村地区建立全科医生与耳鼻咽喉科医生之间的密切关系，并提高耳鼻咽喉科医疗服务的质量。
