Otorrinolaringologia pediátrica no Sistema Público de Saúde de Belo Horizonte

• Autor(a) principal: Guerra, Angela Francisca Marques
• Data de Publicação: 2007
• Outros Autores: Gonçalves, Denise Utsch, Côrtes, Maria da Conceição Juste Werneck, Alves, Claudia Regina Lindgren, Lima, Tânia Mara Assis
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Revista de Saúde Pública
• Texto Completo: https://www.revistas.usp.br/rsp/article/view/32305
• topic: Otorrinolaringopatias^i1^sepidemiolo; Otorrinolaringopatias^i1^sprevenção e contr; Atenção primária à saúde; Atenção secundária à saúde; Atenção à saúde; Serviços de saúde; Pré-escolar; Otorhinolaryngologic diseases^i2^sepidemiol; Otorhinolaryngologic diseases^i2^sprevention & cont; Primary health care; Secondary health care; Health care^i2^sPublic Hea; Health services; Preschool child

OBJECTIVE: To assess the suitability of referral from primary to secondary care in pediatric Otolaryngology. METHODS: The study was performed in the city of Belo Horizonte, in the state of Minas Gerais, from March 2004 to May 2005. A total of 408 pre-school children referred from primary care to secondary care in the department of Otolaryngology presenting with otitis, tonsillitis, sinusitis, allergic rhinitis, and tonsillar/adenoidal hypertrophy was assessed. The studied variables were: agreement between diagnoses in primary and secondary care; waiting time for doctor's appointment; follow-up, and professional (pediatrician or family physician) that examined children in primary care. Agreement of diagnoses was assessed using kappa statistics. RESULTS: Patients were five years old on average, 214 (52.5%) were boys, mean waiting time for appointment was 3.7 months. Diagnoses in primary and secondary care were respectively: otitis (44%, 49%), tonsillar/adenoidal hypertrophy (22%, 33%), tonsillitis (18%, 23%), sinusitis (13%, 21%), allergic rhinitis (3%, 33%). Agreement analysis of kappa was 0.15 for otitis with effusion, 0.35 for recurrent otitis, 0.04 for tonsillar/adenoidal hypertrophy, 0.43 for tonsillitis, 0.05 for allergic rhinitis, and 0.2 for sinusitis. Diagnoses in primary care referred to secondary care were in agreement when given either by pediatrician or family physician. CONCLUSIONS: Unsuitability of referrals from primary to secondary care in otolaryngology was expressed by the long time waiting for appointments and by the low agreement between diagnoses in different level of care for the same patients. Primary health care could be more efficient if professionals were better qualified in Otolaryngology.