Use of tympanometry in general practice in Denmark

Objectives

Otitis media has been a serious disease and can be that even today. The diagnosis of otitis media is often difficult. Pneumatic otoscopy, otomicroscopy, and tympanometry can improve the diagnostic quality by indication of fluid in the middle ear and thereby improve the quality of treatment. The aim of this ongoing study is to analyze the use of tympanometry in Denmark after reimbursement for doing tympanometry (November 2006) when clinically indicated. Our research questions were: How many clinics were using tympanometry? How frequent was it used? Is the use increasing? Has the number of GPs in the clinic any relation to the use of tympanometry?

Method

We used information in The Danish National Health Service in three Regions to analyze the use of tympanometry in general practice during the years 2007–2009. The coverage of the GPs is 100% in the regions.

Results

The three regions counted about half of Danish population. In 2009 the material was 902 different clinics with more than 1700 GPs. In 2007 55% of the clinics did tympanometry, in 2009 the figure was 60%. In the clinics doing tympanometry the median value was 28 tympanometries per year (inter-quartile range 13–53) per GP. The variation in the use of tympanometry was surprisingly high, from none or a few per GP per year to a maximum of more than 500 tympanometric examinations per GP a year. This huge variation has to be discussed.

Discussion

Many answers can be given. Some of the explanation was problems in doing correct tympanometry, and problems understand the clinical implications of curves and the figures.