THE LENGTH OF THE REFERRAL CHAIN AFTER FAILING PRESCHOOL TYMPANOMETRY

Aims. To describe the time intervals during the process of detection a nd management of chronic secretory otitis media/glue ear. Method. Tymp anometry records of 508 preschool children who failed both tympanometr y screening and the subsequent retest were examined. Additional inform ation was obtained from 205 parents/caregivers by telephone interview. Results. Calculations of time intervals between tympanometry screenin g and retesting showed that 75% of children had been retested within 2 0 weeks and 95% by 40 weeks. Two-thirds (67%) of children had visited their general practitioner within 4 weeks of failing their retest, alt hough 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). Conclusion. The preschool tym panometry screening programme functioned well, although there were del ays in retesting 25% of preschoolers. There were substantial time inte rvals for some children for each link in the referral chain. The reaso ns for these delays needs investigation to determine how much it is a part of the treatment process and how much due to waiting list problem s.