Neonatal circumcision availability in the United States: a physician survey.

Autor: Naha U; University of Illinois College of Medicine, Chicago, USA., Arora HC; Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.; Department of Urology, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box 24, Chicago, IL, 60611, USA., Walton RF; Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA., Rosoklija I; Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA., Skibley LM; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, USA., Johnson EK; Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. ekjohnson@luriechildrens.org.; Department of Urology, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box 24, Chicago, IL, 60611, USA. ekjohnson@luriechildrens.org.; Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, USA. ekjohnson@luriechildrens.org.
Jazyk: angličtina
Zdroj: BMC urology [BMC Urol] 2021 Oct 27; Vol. 21 (1), pp. 148. Date of Electronic Publication: 2021 Oct 27.
DOI: 10.1186/s12894-021-00911-7
Abstrakt: Background: A significant proportion of boys present to surgical specialists later in infancy/early childhood for elective operative circumcision despite the higher procedural risks. This study aims to assess physician perspectives on access to neonatal circumcision across the United States and identify potential reasons contributing to disparities in access.
Methods: A cross-sectional survey was electronically distributed to physician members of the Societies for Pediatric Urology and the American Academy of Pediatrics Section on Hospital Medicine. Hospital characteristics and circumcision practices were assessed. Associations between NC availability and institutional characteristics were evaluated using chi-squared testing and multivariable logistic regression. Qualitative analyses of free-text comments were performed.
Results: A total of 367 physicians responded (129 urologists [41%], 188 pediatric hospitalists [59%]). Neonatal circumcision was available at 86% of hospitals represented. On univariate and multivariate analysis, the 50 hospitals that did not offer neonatal circumcision were more likely to be located in the Western region (odds ratio [OR] = 8.33; 95% confidence interval [CI] 3.1-25 vs. Midwest) and in an urban area (OR = 4.2; 95% CI 1.6-10 vs. suburban/rural) compared with hospitals that offered neonatal circumcision. Most common reasons for lack of availability included not a birth hospital (N = 22, 47%), lack of insurance coverage (N = 8, 17%), and low insurance reimbursement (N = 7, 15%). Institutional, regional, or provider availability (68%), insurance/payment (12.4%), and ethics (12.4%) were common themes in the qualitative comments.
Conclusions: Overall availability of neonatal circumcision varied based on hospital characteristics, including geography. Information from this survey will inform development of interventions designed to offer neonatal circumcision equitably and comprehensively.
(© 2021. The Author(s).)
Databáze: MEDLINE
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