OBJECTIVE. Evaluation of referral intention and advance management on tertiary health facility is important to make improvement on allergic treatment among pediatric patients. The objective of this study was to analyze referral reason and profile of allergic children referred to Dr.Soetomo Academic Hospital as tertiary health facility.
METHOD. This was descriptive study from all allergic patients referral based on national health insurance system to allergic and immunology outpatient clinic of Dr.Soetomo Academic Hospital from January until December 2018. Data such as clinical history, referral reason, skin prick test (SPT) result and ongoing therapy were collected from medical record. Analyzed data reported as frequency.
RESULT. There were 208 allergic children referral during 2018. Most patients (95.2%) used national health insurance, 66.1% referred from other hospital in Surabaya. Diagnosis consist of asthma 116(61.4%), allergic rhinitis 22(11.6%), eczema 19(10.1%), and infection cases (sinusitis, recurrent otitis media, and tuberculosis) 32(16.8%) children. Most of subjects had family history of allergic diseases (32.3% father vs 34.9% mother vs 12.7% both parents). Referral reason include unsatisfying patient’s improvement after previous therapy and consultation with pediatric allergist for skin prick test (SPT) were 56.6% and 36.7% respectively. SPT revealed House Dust Mite (HDM) allergy alone or with combination with other type of allergy in 174(84%) children. Immunotherapy was then performed in 177(85.2%) children.
CONCLUSION. Asthma is the most allergic cases in this study. Consultation for SPT and unsatisfying patient’s improvement after therapy from the previous hospital were the most reason of allergic patient referral to our institution. Provision of equipment and materials for SPT and HDM immunotherapy should be considered to be available in secondary health facilities.