Practice variations in the management of sinusitis
Trinh, N.; Ngo, H.H.
Journal of Otolaryngology 29(4): 211-217
2000
ISSN/ISBN: 0381-6605 PMID: 11003071 Document Number: 518018
It has been shown that controlling inappropriate practice variations decreases cost, increases efficiency, and improves quality of health care. The objective of this study was to identify practice variations in the management of acute sinusitis in primary care practice and to explore possible influential factors. A cross-sectional study by mail survey was conducted. Practicing primary care physicians in the province of Quebec were selected for the study. A questionnaire was sent to a random sample of 500 physician members of the Quebec College of Physicians. Three hundred and twenty-seven questionnaires were returned (total response rate = 65.4%), of which 53 were excluded. Two hundred and seventy-four completed surveys were then analyzed. Practice variations in the management of acute sinusitis were observed with respect to diagnostic indicators, the use of diagnostic tools and imagery, prescription of therapeutic agents, factors influencing the choice of antimicrobial agents, and the indications for referral to a specialist. Factors affecting such variations included age, gender, practice region (urban vs. rural), volume of practice, and university affiliation. This survey confirms that confusion exists among primary care physicians about the recommended management of acute sinusitis, despite the recent advent of a multitude of clinical practice guidelines. These variations highlight the need for further research to clarify these issues, as well as better methods and more specific objectives for continuing medical education.