Trends in Pediatric Otolaryngology Disparities Research

Abstract

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.

Impact of Language and Ethnicity on Pediatric Tracheostomy Outcomes

“…1 Community disadvantage has been associated with differences in hospitalization length and costs after pediatric tracheostomy placement regardless of medical complexity. 12 The influence of socioeconomic forces in pediatric otolaryngology is gaining tremendous interest, 28 and a commitment to addressing these factors for pediatric tracheostomy patients is necessary. The current results suggest that among a cohort of children with a tracheostomy and high medical complexity, health disparities by language or ethnicity may have a modest influence on outcomes.…”

The Impact of Socioeconomic Disadvantage on Pediatric Tracheostomy Outcomes

“…[39][40][41] While a growing recognition of the complexities of social, economic, and racial disparities in pediatric otolaryngology has emerged in recent years, the ADI has had limited use except for a single-center retrospective study on adenotonsillectomy indications. [13][14][15]42 Understanding the impact of social determinants of health on outcomes after tracheostomy placement in children is crucial when crafting initiatives to mitigate health disparities. Most children in this tracheostomy registry were from more highly disadvantaged communities.…”

“…Increased awareness in recent years reflects an encouraging trend toward developing strategies to address this challenge. 14,15 An estimated 4,400 pediatric tracheostomies are placed annually in the United States. 16 This procedure is associated with high morbidity among younger children and is a target for quality improvement initiatives.…”

Sociodemographic Disparities in Pediatric Cochlear Implantation Access and Use: A Systematic Review

“…14,40 Last, there is little evidence of disparity in CI rates by insurance status, with only one out of four studies reporting a significantly increased percentage of CI among privately insured deaf children in California. 35 As the heightened interest 49 in researching disparities in pediatric otolaryngology continues, best practices established within the broader arena of disparity literature should be followed to ensure that the time and resources invested result in more robust conclusions. Investigations of disparities in access to CI could be greatly improved with further analysis of the relative contributions of all potential disparity-drivers by multivariable analysis, perhaps utilizing a representative database such as the Kids' Inpatient Database.…”