Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns

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Main Authors: James R. Xu, Anirudh Saraswathula, Paul C. Bryson, Thomas L. Carroll, Lee M. Akst
Format: Artículo Open Access
Published: Wiley 2024
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author James R. Xu
Anirudh Saraswathula
Paul C. Bryson
Thomas L. Carroll
Lee M. Akst
author_facet James R. Xu
Anirudh Saraswathula
Paul C. Bryson
Thomas L. Carroll
Lee M. Akst
James R. Xu
Anirudh Saraswathula
Paul C. Bryson
Thomas L. Carroll
Lee M. Akst
collection Wiley Open Access
contents Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns James R. Xu Anirudh Saraswathula Paul C. Bryson Thomas L. Carroll Lee M. Akst Otolaryngology–Head and Neck Surgery AbstractObjectiveOtolaryngologists play an increasing role in managing cough, but little data exists examining the demographics of this patient population and the referral patterns that influence their access to care. This study sought to elucidate these factors using a longitudinal, nationwide database to minimize sampling bias and identify trends representative of the national population.Study DesignNationally representative survey.SettingNational Ambulatory Medical Care Survey (NAMCS).MethodsVisits with a diagnosis and chief complaint of cough between 2005 and 2019 in NAMCS were examined. Univariable and multivariable analyses were performed to compare patient demographics between visits to surgical specialists, medical specialists, and primary care physicians.ResultsOtolaryngologists made up more than 84% of surgical specialist visits. There was a 0.52% [0.20%‐0.84%] increase per year in the proportion of visits attributed to surgical specialists. Based on a sensitivity analysis of the multivariable model, Hispanic patients (adjusted odds ratio, aOR: 0.88 [0.78‐0.99] vs White) and patients living outside of metropolitan areas (aOR: 0.77 [0.61‐0.99] vs living within) were less likely to see surgical specialists than primary care doctors for their cough. Patients who were referred (aOR: 1.47 [1.28‐1.72] vs not referred) and with chronic cough (aOR: 1.47 [1.23‐1.75] vs acute/subacute) were more likely to see a surgical specialist.ConclusionOtolaryngologists are increasingly called upon to evaluate and consider treatment for cough. Identifying patient groups with limited access underscores the need for enhanced education about otolaryngologists' roles and integrated care approaches to improve access to specialized cough treatment.Level of EvidenceLevel 4. 10.1002/ohn.975 http://creativecommons.org/licenses/by-nc-nd/4.0/
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spellingShingle Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns
James R. Xu
Anirudh Saraswathula
Paul C. Bryson
Thomas L. Carroll
Lee M. Akst
Otolaryngology–Head and Neck Surgery
Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns James R. Xu Anirudh Saraswathula Paul C. Bryson Thomas L. Carroll Lee M. Akst Otolaryngology–Head and Neck Surgery AbstractObjectiveOtolaryngologists play an increasing role in managing cough, but little data exists examining the demographics of this patient population and the referral patterns that influence their access to care. This study sought to elucidate these factors using a longitudinal, nationwide database to minimize sampling bias and identify trends representative of the national population.Study DesignNationally representative survey.SettingNational Ambulatory Medical Care Survey (NAMCS).MethodsVisits with a diagnosis and chief complaint of cough between 2005 and 2019 in NAMCS were examined. Univariable and multivariable analyses were performed to compare patient demographics between visits to surgical specialists, medical specialists, and primary care physicians.ResultsOtolaryngologists made up more than 84% of surgical specialist visits. There was a 0.52% [0.20%‐0.84%] increase per year in the proportion of visits attributed to surgical specialists. Based on a sensitivity analysis of the multivariable model, Hispanic patients (adjusted odds ratio, aOR: 0.88 [0.78‐0.99] vs White) and patients living outside of metropolitan areas (aOR: 0.77 [0.61‐0.99] vs living within) were less likely to see surgical specialists than primary care doctors for their cough. Patients who were referred (aOR: 1.47 [1.28‐1.72] vs not referred) and with chronic cough (aOR: 1.47 [1.23‐1.75] vs acute/subacute) were more likely to see a surgical specialist.ConclusionOtolaryngologists are increasingly called upon to evaluate and consider treatment for cough. Identifying patient groups with limited access underscores the need for enhanced education about otolaryngologists' roles and integrated care approaches to improve access to specialized cough treatment.Level of EvidenceLevel 4. 10.1002/ohn.975 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns
topic Otolaryngology–Head and Neck Surgery
url https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.975