IADR Abstract Archives
The Analysis of the Referral Pattern in Oral Medicine
Objectives: The aim of this study was to analyze referral patterns in an oral medicine (OM) unit of Southern Italy and to identify current barriers in the referral process.
Methods: All new OM visits at Federico II University of Naples between July 2020 and January 2021 were identified. Patient demographics, referral source, time between onset and OM consultation, number and types of providers seen before referral, referral diagnoses and visit diagnoses were recorded.
Results: 583 patients were recruited, 292 proceeding from the public health service and 291 from intramœnia private practice. 281 were males and 365 females, the mean age was 56,6±16,2 years. Almost all the patients were Caucasian (99,7%). Initial diagnosis, when available, was confirmed 167 (54,1%) times. 47% of the sample had an unclear or no initial diagnosis with an higher percentage in patients proceeding from public health service than in those proceeding from intramœnia private practice. On the other hand, patients proceeding from intramœnia private practice have been visited by an higher number of clinicians (2,6) than public health patients (1,4) before attending our center. The rates of correct identification for health-care professionals were the following: dentists (54,8%), general doctors (65,4%), maxilla-facial surgeons (50%), ENT (57,1%), dermatologists (33,3%) and rheumatologists (66,7%), others (55,6%). The rates of correct identification of the most frequent (>5) lesions were the following: aphthosis minor (8/10; 80%) burning mouth syndrome (42%), oral carcinoma (36,3%), exfoliatio areata linguae (12,5%), fibroma (27,3%), HPV-related lesions (100%), leucoplakia (86,7%), oral lichen planus (70,1%), osteonecrosis of the jaws (90,9%), persistent idiopathic facial pain (0%).
Conclusions: This is the first study in Italy to assess referral patterns to a specialized OM unit. Most referrals to OM are appropriate, but many are misdiagnosed. Understanding referral process is necessary to improve patient care.
Methods: All new OM visits at Federico II University of Naples between July 2020 and January 2021 were identified. Patient demographics, referral source, time between onset and OM consultation, number and types of providers seen before referral, referral diagnoses and visit diagnoses were recorded.
Results: 583 patients were recruited, 292 proceeding from the public health service and 291 from intramœnia private practice. 281 were males and 365 females, the mean age was 56,6±16,2 years. Almost all the patients were Caucasian (99,7%). Initial diagnosis, when available, was confirmed 167 (54,1%) times. 47% of the sample had an unclear or no initial diagnosis with an higher percentage in patients proceeding from public health service than in those proceeding from intramœnia private practice. On the other hand, patients proceeding from intramœnia private practice have been visited by an higher number of clinicians (2,6) than public health patients (1,4) before attending our center. The rates of correct identification for health-care professionals were the following: dentists (54,8%), general doctors (65,4%), maxilla-facial surgeons (50%), ENT (57,1%), dermatologists (33,3%) and rheumatologists (66,7%), others (55,6%). The rates of correct identification of the most frequent (>5) lesions were the following: aphthosis minor (8/10; 80%) burning mouth syndrome (42%), oral carcinoma (36,3%), exfoliatio areata linguae (12,5%), fibroma (27,3%), HPV-related lesions (100%), leucoplakia (86,7%), oral lichen planus (70,1%), osteonecrosis of the jaws (90,9%), persistent idiopathic facial pain (0%).
Conclusions: This is the first study in Italy to assess referral patterns to a specialized OM unit. Most referrals to OM are appropriate, but many are misdiagnosed. Understanding referral process is necessary to improve patient care.