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Referrals for recurrent respiratory tract infections including otitis media in young children

Alma C van de Pol1, Anne C van der Gugten, Cornelis K van der Ent

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.

International Journal of Pediatric Otorhinolaryngology
|April 10, 2013
PubMed

Insights

Recurrent respiratory tract infections (RTI) in young children are mainly referred based on disease factors like frequency and severity. General practitioner (GP) experience and daycare attendance also play a role, but guideline adherence is only moderate.

Area of Science:

  • Pediatrics
  • General Practice
  • Health Services Research

Background:

  • Recurrent respiratory tract infections (RTI) are common in young children.
  • Appropriate specialist referral is crucial for managing recurrent RTI.
  • Understanding factors influencing referral decisions and guideline adherence is important for optimizing care.

Purpose of the Study:

  • To identify disease-related, child-related, and physician-related factors associated with specialist referral for recurrent RTI in young children.
  • To assess general practitioners' adherence to national guidelines for these referrals.

Main Methods:

  • Electronic health records of children under 24 months with RTI episodes were analyzed.
  • Child-related factors were obtained from the WHISTLER birth-cohort study.
  • Referral data were compared against national guideline recommendations for adherence.

Main Results:

  • Disease factors, including the number, severity, and duration of RTI episodes, were primary determinants for specialist referral.
  • Non-disease factors such as daycare attendance and general practitioner (GP) experience also showed associations with referral.
  • Fifty-seven percent of referrals for recurrent RTI aligned with national guidelines.

Conclusions:

  • Specialist referral for recurrent RTI in young children is predominantly driven by disease characteristics.
  • The impact of non-disease factors on referral decisions is limited.
  • Current guideline adherence for specialist referrals in recurrent RTI cases is suboptimal, with just over half of referrals being compliant.
Abstract

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