The length of the referral chain after failing preschool tympanometry.
OBJECTIVE
To describe the time intervals during the process of detection and management of chronic secretory otitis media/glue ear.


METHODS
Tympanometry records of 508 preschool children who failed both tympanometry screening and the subsequent retest were examined. Additional information was obtained from 205 parents/caregivers by telephone interview.


RESULTS
Calculations of time intervals between tympanometry screening and retesting showed that 75% of children had been retested within 20 weeks and 95% by 40 weeks. Two-thirds (67%) of children had visited their general practitioner within 4 weeks of failing their retest, although 13% had still yet to be seen by 20 weeks. The mean time interval between the initial general practitioner visit and subsequently being seen by an ENT specialist was 20 weeks in the public system compared to 5 weeks if seen privately (p < 0.001).


CONCLUSIONS
The preschool tympanometry screening programme functioned well, although there were delays in retesting 25% of preschoolers. There were substantial time intervals for some children for each link in the referral chain. The reasons for these delays needs investigation to determine how much it is a part of the treatment process and how much due to waiting list problems.
Community Paediatric Unit, Healthlink South, Christchurch.
O
O
Claridge
R P
RP
Ford
P J
PJ
Schluter
C J
CJ
Wild
L
L
Macleod
D000158:Acoustic Impedance Tests; D002675:Child, Preschool; D002908:Chronic Disease; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening; D008876:Middle Ear Ventilation; D009520:New Zealand; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000601:surgery; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012578:Schools, Nursery; D018709:Statistics, Nonparametric; D013997:Time Factors