Otologic diagnoses in the elderly: current utilization and predicted workload increase

Abstract

Objectives/hypothesis: To establish the current outpatient workload for otologic conditions in the elderly and to estimate its potential increase based on an anticipated aging population.

Study design: Cross-sectional analysis of a national database.

Methods: All outpatient clinic visits for patients aged ≥ 65 years receiving one of six common otologic diagnoses from 2005 to 2007 in the United States were determined from the National Ambulatory Medical Care Survey. The distribution of the visits for these diagnoses across 15 specialties was assessed. The number of visits was projected to the 2020 population based on changes in population demographics predicted by the US Census Bureau.

Results: An estimated 4.48 ± 0.49 million clinic visits with an otologic issue as a coded diagnosis were conducted in 2005 to 2007 in patients aged ≥ 65 years. These consisted of 230,000 visits for benign positional paroxysmal vertigo, 263,000 visits for vestibular neuritis, 292,000 visits for Meniere's disease, 1.09 million visits for tinnitus, and 2.85 million visits for sensorineural hearing loss. Otolaryngology, internal medicine, family practice, and neurology managed the most visits, seeing 57.0%, 21.0%, 14.3%, and 2.2% of the cases, respectively. With expected changes in population demographics by 2020, annual clinic visits for an otologic diagnosis will increase from 1.49 ± 0.78 million to 2.14 million visits in the elderly, annualized, including 1.218 million visits to otolaryngology.

Conclusions: These data quantify the current outpatient otology workload and predict a substantial increase for many specialties, including otolaryngology. Efforts to prepare for this increase including manpower planning and education appear imperative.