Advanced Practice Provider Clinics: Expediting Care For Children Undergoing Tympanostomy Tube Placement
| Autor: | Grant R. Martsolf, Amber D. Shaffer, Kathryn A. Williams, Annie Yan, David H. Chi, Edward S. Sim, Michael A. Belsky, Anisha Konanur, Noel Jabbour |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent medicine.medical_treatment Tertiary care Health Services Accessibility Time-to-Treatment Craniofacial Abnormalities Otolaryngology 03 medical and health sciences 0302 clinical medicine Recurrence Otolaryngologists Prevalence medicine Humans 030212 general & internal medicine Tympanostomy tube Child Hearing Loss 030223 otorhinolaryngology Provider type Advanced Practice Nursing business.industry Retrospective cohort study Evidence-based medicine Middle Ear Ventilation Otitis Media Otorhinolaryngology Acute Disease Preoperative Period Linear Models Female Pediatric otolaryngology Down Syndrome Bilateral myringotomy business |
| Zdroj: | The Laryngoscope. 131:2133-2140 |
| ISSN: | 1531-4995 0023-852X |
| DOI: | 10.1002/lary.29477 |
| Popis: | Advanced practice provider (APP) employment is becoming common in pediatric otolaryngology practices, though few studies have evaluated the consequences that APP-led clinics have on access to care. The objectives of this study were: 1) to investigate whether access to bilateral myringotomy with tympanostomy tube placement (BMT) for recurrent acute otitis media (RAOM) differed between patients seen in otolaryngologist and APP-led clinics 2) to compare clinical characteristics of patients seen by provider type.Retrospective cohort study at an academic, tertiary care pediatric otolaryngology practice. All children were18 years old and underwent evaluation for RAOM followed by BMT. We compared time in days from scheduling pre-operative appointment to appointment date and time from appointment to BMT between patients seen by APPs and otolaryngologists using Mann-Whitney U tests and multivariate linear regression models. We compared clinical characteristics by provider type using Mann-Whitney U tests and Fisher exact tests.A total of 957 children were included. Children seen by APPs had significantly shorter wait times for appointments (median 19 vs. 39 days, P .001) and shorter times from preoperative appointment to BMT (median 25 vs. 37 days, P .001). Patients seen by otolaryngologists had increased prevalence of craniofacial abnormalities, Down Syndrome, hearing loss, history of otologic surgery, and higher ASA physical status classification.Children seen by APPs received care more quickly than those seen by otolaryngologists. Patients seen by otolaryngologists tended to be more medically complex. Implementation of independent APP clinics may expedite and improve access to BMT for children with RAOM.3 Laryngoscope, 131:2133-2140, 2021. |
| Databáze: | OpenAIRE |
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