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Do demographic disparities exist in the diagnosis and surgical management of otitis media?
Author(s) -
Chang Janice Erica,
Shapiro Nina Lisbeth,
Bhattacharyya Neil
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27396
Subject(s) - myringotomy , medicine , otitis , ambulatory , medicaid , ethnic group , incidence (geometry) , pediatrics , health care , demography , surgery , physics , sociology , anthropology , optics , economics , economic growth
Objective Determine if demographic disparities exist between the diagnosis of otitis media (OM) and the provision of myringotomy and tubes in children. Study Design Cross‐sectional analysis of a national database. Methods The National Ambulatory Medical Care Survey 2010 and the National Hospital Ambulatory Medical Care Survey–Ambulatory Surgery 2010 were abstracted for cases with a diagnosis of OM and myringotomy and tube (MT) procedures in children, respectively. Sex, race, ethnic, and insurance distributions were computed for OM and MT and then compared for healthcare disparities between rates of OM diagnoses and MT procedures. Results A total of 13.6 million ambulatory pediatric OM diagnoses were identified in 2010 (55.9% male; 82.4% white, 11.3% black, and 6.3% other; 14.3% Hispanic, 85.7% non‐Hispanic). A total of 413 thousand ambulatory myringotomy procedures were identified (59.6% male; 86.0% white, 11.0% black, and 3.0% other; 13.0% Hispanic, 87.0% non‐Hispanic). There was no statistically significant difference in the provision of MT versus OM diagnosis according to sex ( P  = 0.400), race ( P  = 0.313), or ethnicity ( P  = 0.228). There was also no statistically significant difference in the percentage of Medicaid coverage for OM children (37.0%) versus those undergoing MT (31.1%; P  = 0.376). There does, however, appear to be a statistically higher percentage of non‐Hispanic children being diagnosed with otitis media than Hispanic children ( P  = 0.049). Conclusion There were no significant demographic differences in the incidence of children with OM undergoing MT with respect to sex, race, ethnicity, or insurance status. As a specialty, otolaryngology does not appear to exhibit any disparate healthcare access bias in providing MT to children with OM. Level of Evidence NA Laryngoscope , 128:2898–2901, 2018

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