Healthcare disparities in pediatric otolaryngology: A systematic review

Jabbour, Jad; Robey, Thomas; Cunningham, Michael J.

doi:10.1002/lary.26995

Cited by 66 publications

(78 citation statements)

References 78 publications

(211 reference statements)

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“…Disparities in healthcare delivery in pediatric otolaryngology have been well-documented, arising from multiple factors including race, socioeconomic status, insurance status, and access to care. 1 This has been demonstrated in children with a variety of otolaryngologic conditions, such as hearing loss, 2,3 rhinosinusitis, 4,5 sleep-disordered breathing, 6,7 and otitis media. [7][8][9] Lack of timely care can lead to differences in outcomes and development.…”

Section: Introductionmentioning

confidence: 98%

Relationship between Insurance Type and Delays in Tympanostomy Tube Placement

Schwartz

Shah

Wetzel

2020

Ann Otol Rhinol Laryngol

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Objective: To investigate the role of insurance carriers and changes in insurance on rates of cancelation and rescheduling of tympanostomy tube surgery. Methods: Retrospective cohort study between January 1, 2013 and December 31, 2018 at a single tertiary care academic pediatric otolaryngology practice of pediatric patients (≤18 years) who underwent tympanostomy tube placement for any indication. Patients had to have insurance providers recorded both at clinic visit and at the time of surgery. Rates of cancelation and postponement of tympanostomy tube placement were assessed. Logistic regression was performed to determine factors associated with cancelation or postponement of surgery. Results: Of the 5080 patients, 2961 patients had Medicaid and 2012 patients had private insurance at the time of surgery. A total of 197 (3.96%) patients switched insurance between clinic appointment and date of surgery. Time to surgery was nearly 2 weeks more for those who had a change in insurance vs. those who did not (33 vs. 20 days, P < .001). Those who switched insurance were nearly twice as likely to have to reschedule surgery than those who did not (OR 1.95, CI 1.42-2.67). Patients who had Medicaid as the primary payer also had increased odds of needing to reschedule and postpone surgery (OR 1.39, 95% CI 1.17-1.63). Conclusion: Difference in insurance carrier and loss/change of insurance appear to be associated with delays in tympanostomy tube placement. Standardization of re-enrollment schedules across insurance providers or a single payer model may be useful in addressing these delays in care.

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Section: Introductionmentioning

confidence: 98%

Relationship between Insurance Type and Delays in Tympanostomy Tube Placement

Schwartz

Shah

Wetzel

2020

Ann Otol Rhinol Laryngol

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“…They are harmful not only to the individuals and communities that experience them but also to the nation as a whole by increasing the social burden of the overall health care system. 4 Health care disparities are affected by various factors, including race, SES, patient comorbidity, and others. 5,6 Among these factors, SES is one of the fundamental predictors of health care outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…They are harmful not only to the individuals and communities that experience them but also to the nation as a whole by increasing the social burden of the overall health care system. 4…”

Section: Introductionmentioning

confidence: 99%

The Impact of Socioeconomic Status on Hospital Accessibility in Otorhinolaryngological Disease in Korea

Hong

Kim

2020

Asia Pac J Public Health

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This study aimed to investigate the impact of socioeconomic status (SES) on otorhinolaryngology disease severity status diagnosed at the first hospital visit. We conducted a retrospective study over 20 years (2000-2019). Otorhinolaryngological diseases included chronic rhinosinusitis (CRS), sensorineural hearing loss (SNHL), oral ulcer, and malignant neoplasms. A logistic regression model was employed to assess the effect of SES on the severity of each disease at the first hospital visit. The severity of CRS increased in patients with lower SES ( P = .028). The severities of SNHL ( P = .032) and oral ulcer ( P < .001) also associated with SES. In contrast, between the low- and high-SES groups observed no differences in cancer stage ( P = .845). Patients with SNHL, oral ulcer, and CRS had a more severe disease status in the low-SES group than in the high-SES group at the first hospital visit. Efforts to increase hospital accessibility for low-SES otorhinolaryngological patients should be made.

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“…Given the total numbers of 3977 and 4841 pediatric articles published in those journals over these respective periods, the comparative rates of disparities-related articles were 1.3 (95% CI, 0.5-3.2) per 1000 from 2003 to 2009 and 5.4 (95% CI, 3.6-8.0) per 1000 from 2010 to 2016 ( P < .001). Of 61 articles related to disparities in pediatric otolaryngology published at any time and in any journal, 14 39 (63.9%) were published in 2010 or later.…”

Section: Resultsmentioning

confidence: 99%

Trends in Pediatric Otolaryngology Disparities Research

Jabbour

Doerfer

Robey

et al. 2018

Otolaryngol.--head neck surg.

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Objectives To describe trends in disparities research within pediatric otolaryngology as evidenced by major meeting presentations and to compare observed trends with those in the realm of patient safety and quality improvement (PSQI). Study Design Retrospective review of presentations at national otolaryngology meetings. Setting Online review of meeting programs. Subjects and Methods Meeting programs from the American Society of Pediatric Otolaryngology, Triological Society, American Academy of Otolaryngology-Head and Neck Surgery Foundation, and Society for Ear, Nose and Throat Advances in Children from 2003 to 2016 were manually searched for pediatric oral and poster presentations addressing disparities and socioeconomic determinants of health, as well as PSQI. Presentation frequency was compared between categories and within each category over time. Results Of 11,311 total presentations, 3078 were related to the pediatric population, and 1945 (63.2%) of those were oral presentations. Disparities-related presentations increased from 0 in 2003 to 17 in 2016. From 2003 to 2009, 9 of 656 (1.4%) presentations involved disparities, as opposed to 70 of 2422 (2.9%) from 2010 to 2016 ( P = .03). The proportion of presentations regarding PSQI also increased: from 42 of 656 (6.4%) in 2003-2009 to 221 of 2422 (9.1%) in 2010-2016 ( P = .01). PSQI presentations remain more common than disparities presentations (9.1% vs 2.9%, P < .001). Conclusion Health care disparities are increasingly addressed in pediatric otolaryngology meeting presentations. Compared with the well-established realm of PSQI, disparities research remains nascent but is gaining attention. Health care reform and quality improvement efforts should recognize the role of socioeconomic factors and include strategies for addressing disparities.

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Healthcare disparities in pediatric otolaryngology: A systematic review

Cited by 66 publications

References 78 publications

Relationship between Insurance Type and Delays in Tympanostomy Tube Placement

Relationship between Insurance Type and Delays in Tympanostomy Tube Placement

The Impact of Socioeconomic Status on Hospital Accessibility in Otorhinolaryngological Disease in Korea

Trends in Pediatric Otolaryngology Disparities Research

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