Assessment of Health Care Utilization for Dizziness in Ambulatory Care Settings in the United States.
Otol Neurotol
; 40(9): e918-e924, 2019 10.
Article
en En
| MEDLINE
| ID: mdl-31498294
ABSTRACT
OBJECTIVE:
Describe patient and physician characteristics, and physician recommendations for ambulatory care visits for dizziness in the US. STUDYDESIGN:
Cross-sectional analysis of visits for dizziness from the National Ambulatory Medical Care Survey (2013-2015).SETTING:
Ambulatory care clinics in the US. PATIENTS 20.6 million weighted adult visits [mean age 58.7 (1.0)] for dizziness, identified using ICD-9-CM codes (386.00-386.90, 780.40). MAIN OUTCOMEMEASURES:
Patient, clinical, and physician characteristics and physician diagnostic and treatment recommendations. Prevalence rates for benign paroxysmal positional vertigo (BPPV), unspecified dizziness, and other vestibular disorders were estimated, and descriptive statistics were used to characterize patients, physicians, and physicians' recommendations.RESULTS:
The prevalence rate for dizziness visits was 8.8 per 1,000 (95% confidence interval [CI] 7.5, 10.3). Most visits were for unspecified dizziness (75%), made by women (65%), whites (79%), and were insured by private insurance (50%). Visits for dizziness were to primary care physicians (51.9%), otolaryngologists (13.3%), and neurologists (9.6%). Imaging was ordered and medication prescription was provided in 5.5% and 20.1% of visits. Physical therapy (PT) was used for a higher percentage of BPPV visits (12.9%), than for other diagnoses (<1.0%). Physician treatment recommendations for vestibular diagnoses varied by physician specialty.CONCLUSIONS:
A large percentage of visits had an unspecified diagnosis. A low number of visits for vestibular disorders were referred to PT. There are opportunities to improve care by using specific diagnoses and increasing the utilization of effective interventions for vestibular disorders.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Aceptación de la Atención de Salud
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Mareo
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Atención Ambulatoria
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Vértigo Posicional Paroxístico Benigno
Tipo de estudio:
Guideline
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Otol Neurotol
Asunto de la revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Año:
2019
Tipo del documento:
Article