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Racial and Ethnic Disparities in Otolaryngology Office Visit and Tympanostomy Tube Placement in Children with Otitis Media.
- Source :
-
The Laryngoscope [Laryngoscope] 2024 Aug; Vol. 134 (8), pp. 3846-3852. Date of Electronic Publication: 2024 Mar 07. - Publication Year :
- 2024
-
Abstract
- Objectives: Racial disparities are pervasive in access to pediatric surgery. The goal of this study was to test the hypotheses that, compared with White children, non-White and Hispanic children: (1) were less likely to attend evaluations by otolaryngologists after a diagnosis of otitis media (OM) eligible for surgical referral, and (2) these children were less likely to receive tympanostomy tube (TT) after surgical consultation.<br />Methods: The OptumLabs Data Warehouse is a de-identified claims database of privately insured enrollees. Guidelines on the management of OMs suggest that children should be evaluated for surgery if they have recurrent acute OM or chronic OM with effusion. A cohort of children who were diagnosed with OM were constructed. For Hypothesis 1, the primary outcome was otolaryngology office visit within 6 months of a diagnosis of recurrent or chronic OM. For Hypothesis 2, the outcome was TT placement within 6 months following the otolaryngology office visit. Cox regression models were used to determine the relationship between race/ethnicity and the primary outcomes.<br />Results: Among 187,776 children with OMs, 72,774 (38.8%) had otolaryngology visits. In a multivariate Cox model, the hazard ratios of attending otolaryngology visit for Black, Hispanic, and Asian children were 0.93 (95% CI,0.90, 0.96), 0.86 (0.83, 0.88), and 0.74 (0.71, 0.77), compared with White children. Among the children evaluated by otolaryngologists, 46,554 (63.97%) received TT. Black, Hispanic, and Asian children with recurrent acute OM had lower likelihood of receiving TT.<br />Conclusions: Racial disparities in attending otolaryngology office visit contributed to the disparities in receiving TT.<br />Quality of Evidence: Level 3 Laryngoscope, 134:3846-3852, 2024.<br /> (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
- Subjects :
- Humans
Female
Male
Child, Preschool
Child
Infant
Otolaryngology statistics & numerical data
United States
Ethnicity statistics & numerical data
Hispanic or Latino statistics & numerical data
White People statistics & numerical data
Retrospective Studies
Middle Ear Ventilation statistics & numerical data
Otitis Media surgery
Otitis Media ethnology
Healthcare Disparities statistics & numerical data
Healthcare Disparities ethnology
Office Visits statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 134
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 38450789
- Full Text :
- https://doi.org/10.1002/lary.31380