Ambulatory visits for common rhinologic complaints in the United States: A patient-centered perspective.

Abstract

The National Ambulatory Medical Care Survey (NAMCS) is a collection of publicly available and deidentified patient data gathered from participating tertiary medical centers. With it, this study attempts to describe and quantify distribution of patients presenting with a rhinologic reason for visit (RFV) in the ambulatory setting, as well as determine the distribution based on specialty and setting of practice. Data from years 2014-2016 in the NAMCS were analyzed to determine the overall number of visits for a rhinologic RFV, the distribution according to RFV, the medical specialty of the clinical provider and patient demographics. 20.1 Million ambulatory visits with a rhinologic RFV, annualized, were identified. The dominant RFVs were nasal congestion (41.9%), sinus problems (14.5%), sinus pain/pressure (10.6%), hay fever (10.5%), sinus congestion (7.5%), sinus inflammation or infection (5.7%), and epistaxis (4.0%). The majority of the most common complaints were addressed by primary care physicians (64.5% of nasal congestion, 63.9% of sinus problems, and 75.7% of sinus pain/pressure), whereas epistaxis, disturbances of sense, and inflammation of the nose were more likely to be addressed by an otolaryngologist (58.9%, 28.8%, and 63.0%, respectively). Non-metropolitan areas generated more primary care visits (90.1%) than metropolitan areas (50.2%) (p < 0.001). The Northeast garnered the highest number of otolaryngology visits (32.4%) and lowest of primary care (59.1%). Patients with common rhinologic complaints present to primary care more frequently than to otolaryngology, though this pattern varies depending on the specific rhinologic RFV and depending on region and setting of practice. This article is protected by copyright. All rights reserved.