Department of Health Management and Informatics, College of Community Innovation and Education, University of Central Florida, Orlando, Florida, USA.
School of Communication Sciences and Disorders, College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA.
Otolaryngol Head Neck Surg. 2021 Mar;164(3):667-674. doi: 10.1177/0194599820953381. Epub 2020 Sep 15.
To evaluate the association between race/ethnicity and insurance status on the access to early cochlear implantation.
Population-based retrospective analysis of pediatric cochlear implantation procedures.
State Ambulatory Surgery and Services Databases of Florida from 2005 to 2017.
All children aged 18 years or younger in the state of Florida undergoing cochlear implantation were identified. The outcome measures were access to early cochlear implantation (before 1 and 2 years of age). Descriptive and multivariate logistic regression analyses were conducted.
Among 1511 pediatric cochlear implantation procedures with complete data, 65 (4.3%) procedures were performed by 1 year of age and 348 (23.0%) by 2 years of age. Black children (odds ratio [OR], 0.44; 95% CI, 0.28-0.70), Hispanic children (OR, 0.70; 95% CI, 0.52-0.94), and children with Medicaid (OR, 0.64; 95% CI, 0.48-0.84) were significantly less likely to be implanted before 2 years of age. Even when insured by private insurance, black and Hispanic children were still less likely to be implanted before 2 years of age compared to white children with private insurance. Greater racial and insurance disparities existed in access to cochlear implantation before 1 year of age compared to implantation before 2 years of age.
Racial/ethnic and insurance disparities in pediatric cochlear implantation can be observed at the population level. To address these racial and insurance inequalities, a multidisciplinary care team is needed and priorities should be given to research endeavors and policy interventions that target these disparities.
评估种族/民族和保险状况对早期人工耳蜗植入的获取的影响。
基于人群的儿科人工耳蜗植入手术回顾性分析。
佛罗里达州州立门诊手术和服务数据库，2005 年至 2017 年。
在佛罗里达州，确定所有年龄在 18 岁以下接受人工耳蜗植入的儿童。主要结果为早期人工耳蜗植入（1 岁和 2 岁之前）的获取情况。进行了描述性和多变量逻辑回归分析。
在 1511 例有完整数据的儿科人工耳蜗植入手术中，有 65 例（4.3%）在 1 岁前进行，348 例（23.0%）在 2 岁前进行。黑人儿童（比值比 [OR]，0.44；95%置信区间 [CI]，0.28-0.70）、西班牙裔儿童（OR，0.70；95% CI，0.52-0.94）和有医疗补助（Medicaid）的儿童（OR，0.64；95% CI，0.48-0.84）植入前 2 岁的可能性显著降低。即使有私人保险，黑人儿童和西班牙裔儿童在 2 岁之前植入的可能性仍低于有私人保险的白人儿童。在 1 岁之前获得人工耳蜗植入与 2 岁之前相比，存在更大的种族和保险差异。
在儿科人工耳蜗植入方面，可以观察到种族/民族和保险方面的差异。为了解决这些种族和保险方面的不平等问题，需要一个多学科的护理团队，并优先考虑针对这些差异的研究工作和政策干预措施。
