Sociodemographic Factors and Health Care Utilization in Pediatric Chronic Suppurative Otitis Media

Abstract

Objectives Access to and utilization of perioperative healthcare may influence outcomes in patients with chronic suppurative otitis media (CSOM); however, the influencing factors are poorly understood. The objective of this study was to assess the association of sociodemographic factors with perioperative health care utilization for pediatric CSOM patients. Methods We conducted a review on pediatric CSOM patients (≤18 years old) who underwent tympanoplasty with/without mastoidectomy between 2010 and 2020. Sociodemographic data and clinical were collected on all participants. Univariate and multivariate logistic regression analysis was conducted to assess the association between these factors and perioperative care utilization. Results 427 patients were included in the study. The primary factor associated with health care utilization was insurance status. Rural children were more likely to have Medicaid insurance (p = 0.048). For tympanoplasty patients, Medicaid patients have 1.66 higher odds of pre‐operative no‐shows (p = 0.01), 1.31 higher odds of post‐operative no‐shows (p = 0.02), and 59% lower odds of having a postoperative audiogram (p = 0.01), and 2.64 higher odds of being from a rural community (p = 0.02). For patients undergoing mastoidectomy, Medicaid patients have 1.25 higher odds of postoperative no‐shows (p = 0.01), 39% lower odds of having a revision procedure for ossicular reconstruction (p = 0.045). Appalachian rural mastoidectomy patients had 3.62 higher odds of having cholesteatoma (p = 0.05). Conclusion Pediatric patients with CSOM who have Medicaid insurance, especially those who reside in rural regions, are at risk for lower perioperative hearing health care utilization. As these findings may impact care delivery and clinical outcomes, efforts should be focused on promoting utilization among these populations. Level of Evidence 4 Laryngoscope, 133:700–705, 2023

Impact of Habitual Yogurt Intake in Mother–Child Dyads on Incidence of Childhood Otitis Media: The Japan Environment and Children’s Study (JECS)

“…The design of the questionnaire used in the survey has been previously described in detail [25,26,31]. In brief, sociodemographic, health, and lifestyle confounders in mother-infant dyads, which are associated with the incidence of childhood otitis media [3,5], were included in the analyses as covariates. The data retrieval was performed using medical transcription reports and self-administered questionnaires [32][33][34].…”

“…Otitis media encompasses a spectrum of diseases related to in ammation in the middle ear, including acute otitis media, otitis media with effusion, and chronic suppurative otitis media [1][2][3][4]. The condition is one of the most common diseases of childhood, with more than half of children experiencing it at least once before three years of age [2,3,5]. Additionally, Wald et al [6] reported that infants with a rst episode of otitis media early in life (aged < 12 months) are more susceptible to recurrent otitis media.…”