Chang Janice Erica, Shapiro Nina Lisbeth, Bhattacharyya Neil
Department of Head and Neck Surgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California.
the Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Laryngoscope. 2018 Dec;128(12):2898-2901. doi: 10.1002/lary.27396. Epub 2018 Sep 19.
Determine if demographic disparities exist between the diagnosis of otitis media (OM) and the provision of myringotomy and tubes in children.
Cross-sectional analysis of a national database.
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.
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).
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.
NA Laryngoscope, 128:2898-2901, 2018.
确定儿童中耳炎（OM）诊断与鼓膜切开置管术实施之间是否存在人口统计学差异。
对国家数据库进行横断面分析。
分别从《2010年国家门诊医疗护理调查》和《2010年国家医院门诊医疗护理调查 - 门诊手术》中提取儿童中耳炎诊断病例及鼓膜切开置管（MT）手术病例。计算中耳炎和鼓膜切开置管术的性别、种族、民族及保险分布情况，然后比较中耳炎诊断率与鼓膜切开置管术手术率之间的医疗差异。
2010年共确定1360万例门诊儿科中耳炎诊断病例（男性占55.9%；白人占82.4%，黑人占11.3%，其他占6.3%；西班牙裔占14.3%，非西班牙裔占85.7%）。共确定41.3万例门诊鼓膜切开置管手术病例（男性占59.6%；白人占86.0%，黑人占11.0%，其他占3.0%；西班牙裔占13.0%，非西班牙裔占87.0%）。根据性别（P = 0.400）、种族（P = 0.313）或民族（P = 0.228），鼓膜切开置管术实施与中耳炎诊断之间无统计学显著差异。中耳炎患儿的医疗补助覆盖率（37.0%）与接受鼓膜切开置管术患儿的覆盖率（31.1%）相比，也无统计学显著差异（P = 0.376）。然而，非西班牙裔儿童被诊断为中耳炎的比例似乎在统计学上高于西班牙裔儿童（P = 0.049）。
在接受鼓膜切开置管术的中耳炎患儿中，在性别、种族、民族或保险状况方面不存在显著的人口统计学差异。作为一个专业领域，耳鼻喉科在为中耳炎患儿提供鼓膜切开置管术时似乎未表现出任何不同的医疗服务获取偏差。
NA 《喉镜》，2018年，第128卷，第2898 - 2901页
