title: Otolaryngology Needs in a Free Clinic Providing Indigent Care.
abstract: To determine the otolaryngology needs in a free clinic providing care to medically indigent patients, as perceived by the patients and health care providers.
  
  
  
  Cross-sectional survey.
  
  
  
  A survey was administered to patients and health care providers of a free clinic from September 2014 through January 2015 in an urban, inner-city location.
  
  
  
  One hundred and thirty-seven patients (35.8% male, age 50.8 ± 13.0 years) completed the survey. Mean household income was $29,838 ± $10,425; 32.1% spoke English; 54.7% were employed; 10.2% had health insurance; and 37.2% had seen a primary care provider outside of the free clinic. The top three otolaryngology symptoms among patients were sleep apnea/snoring (39.4%), heartburn/reflux (30.7%), and dizziness (29.9%). Eleven health care providers (45% male, age 50.5 ± 15.3 years, 63.6% physician, 36% nurse) completed the survey. Providers perceived the following otolaryngology complaints as the most prevalent, in descending order: cough, nasal congestion, reflux/heartburn, sore throat, and ear infection/otalgia. Providers felt that sleep apnea and hearing loss were the less common otolaryngology complaints, whereas surveyed patients indicated these symptoms with high frequency. The most requested diagnostic tool among patients and providers was chest X-rays.
  
  
  
  There are unmet otolaryngology needs in a free clinic. Medically indigent patients have significant barriers to accessing health care. Patient and provider perceptions of top otolaryngology complaints differed, but both identified access to chest X-rays as a major unmet need. Knowledge of patient perceptions may help providers elicit the breadth of otolaryngology complaints.
  
  
  
  4. Laryngoscope, 126:1321-1326, 2016.
authors.affiliation: Department of Otolaryngology-Head and and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hu
authors.affiliation: Department of Otolaryngology-Head and and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sibert
authors.affiliation: Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Vincent
authors.initials: V
authors.lastname: Zarro
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods*; D015143:Philadelphia; D011203:Poverty / Q000523:psychology; D011795:Surveys and Questionnaires; D017664:Uncompensated Care
keywords: Free clinic; indigent care; otolaryngology