The Impact of Sociodemographic Factors on Rates of Tympanostomy Tube Placement for Pediatric Otitis Media.

Autor: Adams JA; Medical College of Wisconsin Department of Otolaryngology and Communication Sciences Milwaukee Wisconsin USA., Flanary V; Medical College of Wisconsin Department of Otolaryngology and Communication Sciences Milwaukee Wisconsin USA., Thomas A; Medical College of Wisconsin Department of Otolaryngology and Communication Sciences Milwaukee Wisconsin USA., Tong L; Department of Health Informatics and Administration University of Wisconsin-Milwaukee Milwaukee Wisconsin USA., Osinski K; Medical College of Wisconsin, Clinical and Translational Science Institute Milwaukee Wisconsin USA., Luo J; Department of Health Informatics and Administration University of Wisconsin-Milwaukee Milwaukee Wisconsin USA., Friedland DR; Medical College of Wisconsin Department of Otolaryngology and Communication Sciences Milwaukee Wisconsin USA.
Jazyk: angličtina
Zdroj: OTO open [OTO Open] 2024 Jul 04; Vol. 8 (3), pp. e159. Date of Electronic Publication: 2024 Jul 04 (Print Publication: 2024).
DOI: 10.1002/oto2.159
Abstrakt: Objective: To identify the impact of race, ethnicity, and socioeconomic status (SES) on the rate of tympanostomy tube placement.
Study Design: Retrospective medical review and population-level analyses.
Setting: Tertiary referral center.
Methods: Demographic and population-level characteristics (age, gender, race, insurance status, and ZIP code) compared to the regional, health system, and otolaryngology clinic demographics.
Results: Among 38,461 children diagnosed with otitis media (OM) 61.4% were white, 27.4% were black, 32.7% had private insurance, and 18.2% were Hispanic. Among patients seen in the pediatric ear, nose, and throat (ENT) clinics, 70.0% were white, 20.0% were black, 46.6% had private insurance, and 14.9% were Hispanic. Further disparity was noted among those receiving tympanostomy tubes: 75.6% white, 15.6% black, 61.9% private insurance, and 11.7% Hispanic. Higher rates of tube placement were noted for those of white race [odds ratio, OR: 1.96, (95% confidence interval, CI: 1.85-2.04), <.001] and non-Hispanic ethnicity [OR: 1.67, (95% CI: 1.56-1.75), <.001]. Geographically, rates of tube placement were significantly lower in areas with higher deprivation indices, areas with lower proportions of white residents, and areas with the lowest median incomes. These markers correlate strongly with black race and Hispanic ethnicity. Lower rates of tube placement were also seen in majority white locales with higher deprivation indices and lower median incomes.
Conclusion: Rates of access to pediatric ENT clinics, and of tube placement, are significantly lower for those of Hispanic ethnicity and black race than for non-Hispanic white children. Higher rates of tube placement were noted among white children and those with private insurance. Lower rates of tube placement were seen in areas of lower SES regardless of racial demographics.
Competing Interests: The authors note no competing interests relevant to this study.
(© 2024 The Author(s). OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
Externí odkaz: