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Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement.
- Source :
- Annals of Otology, Rhinology & Laryngology; Feb2022, Vol. 131 Issue 2, p182-190, 9p
- Publication Year :
- 2022
-
Abstract
- Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children's hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance (P <.001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P =.003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]
- Subjects :
- HEALTH services accessibility
ACQUISITION of data methodology
CONFIDENCE intervals
CHILDREN'S hospitals
AGE distribution
HEALTH status indicators
RACE
RETROSPECTIVE studies
OTITIS media with effusion
SOCIOECONOMIC factors
RISK assessment
MIDDLE ear ventilation
MEDICAL records
HEALTH insurance
DESCRIPTIVE statistics
AGE factors in disease
ODDS ratio
PATIENT compliance
PEDIATRIC surgery
LONGITUDINAL method
OTITIS media
DISEASE risk factors
SYMPTOMS
CHILDREN
ADOLESCENCE
Subjects
Details
- Language :
- English
- ISSN :
- 00034894
- Volume :
- 131
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Annals of Otology, Rhinology & Laryngology
- Publication Type :
- Academic Journal
- Accession number :
- 154496800
- Full Text :
- https://doi.org/10.1177/00034894211015741