Objectives: This study describes the prevalence of head and neck disease in patients seen at an urban, federally qualified clinic for those experiencing homelessness and determines the need for otolaryngologists in providing health care for the homeless.
Methods: All adult patient visits from 2000 to 2004 were reviewed for ICD-9 diagnostic codes representing otolaryngological diseases. Chart review was performed for patients referred to a volunteer otolaryngologist to confirm diagnoses and referrals.
Results: During the study period, the clinic served 11,690 unique patients in 59,060 patient visits. Otolaryngological diagnoses accounted for 8,959 of these total visits (15.2%), 94% of which were managed by primary care providers. The most common diagnoses were "upper respiratory infections," "symptoms, signs, and ill-defined conditions of the head and neck, cough, dysphagia," "other diseases of upper respiratory tract," and "disorders of the ear/mastoid process." An on-site volunteer otolaryngologist provided consultation on 6% of all patients with otolaryngological diagnoses, averaging 108 consultations per year; 39 patients were subsequently referred to community specialists for surgery and audiology services.
Conclusions: There is a small but significant need for otolaryngologists in providing health care for homeless individuals in an urban setting. The authors encourage otolaryngologists and homeless health-care clinics to establish a relationship for volunteer services.