Diercks Gillian R, Cohen Michael S
Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Newton Wellesley Hospital, Newton, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2022 Jan;166(1):167-170. doi: 10.1177/01945998211008916. Epub 2021 May 4.
To evaluate how the coronavirus disease 2019 (COVID-19) pandemic has affected tympanostomy tube placement and practice patterns.
A retrospective review of billing data.
A large-volume practice with both community and tertiary care providers.
As part of a quality initiative, billing data were queried to identify children <18 years of age who underwent tympanostomy tube placement between January 2019 and December 2020. Patient age, practice location, and case numbers were gathered.
The study included data from 2652 patients. Prior to state-mandated clinic and operating room restrictions, there were no significant differences in the number of tympanostomy tubes placed ( = .64), including month-to-month comparisons, the distribution of patients being cared for at community vs tertiary care sites ( = .63), or patient age at the time of surgery ( = .97) between 2019 and 2020. After resumption of outpatient clinical and elective surgical activities, the number of tympanostomy tubes placed decreased significantly between 2019 and 2020 (831 vs 303 cases, = .003), with a persistent month-to-month difference. In addition, patients undergoing tube placement were older (4.5 vs 3.2 years, < .001). The distribution of cases performed in the community setting decreased during this time period as well ( < .001).
During the COVID-19 pandemic, the rate of pediatric tympanostomy tube placement has significantly decreased. The age of patients undergoing surgery has increased, and more children are being cared for in a tertiary setting. These findings may reflect changes in the prevalence of acute and chronic otitis media as the result of the pandemic.
评估2019冠状病毒病（COVID-19）大流行如何影响鼓膜置管术的实施及实践模式。
对计费数据进行回顾性分析。
一家同时拥有社区和三级医疗服务提供者的大型医疗机构。
作为一项质量改进举措的一部分，查询计费数据以确定在2019年1月至2020年12月期间接受鼓膜置管术的18岁以下儿童。收集患者年龄、医疗机构地点和病例数量。
该研究纳入了2652例患者的数据。在州政府强制实施诊所和手术室限制措施之前，2019年和2020年之间鼓膜置管的数量（P = 0.64）、包括逐月比较、在社区与三级医疗场所接受治疗的患者分布（P = 0.63）或手术时的患者年龄（P = 0.97）均无显著差异。在恢复门诊临床和择期手术活动后，2019年和2020年之间鼓膜置管的数量显著减少（831例对303例，P = 0.003），且逐月差异持续存在。此外，接受置管的患者年龄更大（4.5岁对3.2岁，P < 0.001）。在此期间，社区环境中进行的病例分布也有所下降（P < 0.001）。
在COVID-19大流行期间，小儿鼓膜置管率显著下降。接受手术的患者年龄增加，且更多儿童在三级医疗机构接受治疗。这些发现可能反映了大流行导致的急慢性中耳炎患病率的变化。
