PDF(Pubmed)
Abstract：
UNASSIGNED: To identify the impact of race, ethnicity, and socioeconomic status (SES) on the rate of tympanostomy tube placement.
UNASSIGNED: Retrospective medical review and population-level analyses.
UNASSIGNED: Tertiary referral center.
UNASSIGNED: Demographic and population-level characteristics (age, gender, race, insurance status, and ZIP code) compared to the regional, health system, and otolaryngology clinic demographics.
UNASSIGNED: Among 38,461 children diagnosed with otitis media (OM) 61.4% were white, 27.4% were black, 32.7% had private insurance, and 18.2% were Hispanic. Among patients seen in the pediatric ear, nose, and throat (ENT) clinics, 70.0% were white, 20.0% were black, 46.6% had private insurance, and 14.9% were Hispanic. Further disparity was noted among those receiving tympanostomy tubes: 75.6% white, 15.6% black, 61.9% private insurance, and 11.7% Hispanic. Higher rates of tube placement were noted for those of white race [odds ratio, OR: 1.96, (95% confidence interval, CI: 1.85-2.04), <.001] and non-Hispanic ethnicity [OR: 1.67, (95% CI: 1.56-1.75), <.001]. Geographically, rates of tube placement were significantly lower in areas with higher deprivation indices, areas with lower proportions of white residents, and areas with the lowest median incomes. These markers correlate strongly with black race and Hispanic ethnicity. Lower rates of tube placement were also seen in majority white locales with higher deprivation indices and lower median incomes.
UNASSIGNED: Rates of access to pediatric ENT clinics, and of tube placement, are significantly lower for those of Hispanic ethnicity and black race than for non-Hispanic white children. Higher rates of tube placement were noted among white children and those with private insurance. Lower rates of tube placement were seen in areas of lower SES regardless of racial demographics.
UNASSIGNED: Retrospective medical review and population-level analyses.
UNASSIGNED: Tertiary referral center.
UNASSIGNED: Demographic and population-level characteristics (age, gender, race, insurance status, and ZIP code) compared to the regional, health system, and otolaryngology clinic demographics.
UNASSIGNED: Among 38,461 children diagnosed with otitis media (OM) 61.4% were white, 27.4% were black, 32.7% had private insurance, and 18.2% were Hispanic. Among patients seen in the pediatric ear, nose, and throat (ENT) clinics, 70.0% were white, 20.0% were black, 46.6% had private insurance, and 14.9% were Hispanic. Further disparity was noted among those receiving tympanostomy tubes: 75.6% white, 15.6% black, 61.9% private insurance, and 11.7% Hispanic. Higher rates of tube placement were noted for those of white race [odds ratio, OR: 1.96, (95% confidence interval, CI: 1.85-2.04), <.001] and non-Hispanic ethnicity [OR: 1.67, (95% CI: 1.56-1.75), <.001]. Geographically, rates of tube placement were significantly lower in areas with higher deprivation indices, areas with lower proportions of white residents, and areas with the lowest median incomes. These markers correlate strongly with black race and Hispanic ethnicity. Lower rates of tube placement were also seen in majority white locales with higher deprivation indices and lower median incomes.
UNASSIGNED: Rates of access to pediatric ENT clinics, and of tube placement, are significantly lower for those of Hispanic ethnicity and black race than for non-Hispanic white children. Higher rates of tube placement were noted among white children and those with private insurance. Lower rates of tube placement were seen in areas of lower SES regardless of racial demographics.
摘要：
■为了确定种族的影响，种族,和社会经济地位(SES)对鼓膜置管率的影响。
■回顾性医学回顾和人群水平分析。
■三级转诊中心。
■人口和人口水平特征（年龄，性别,种族,保险状况,和邮政编码)与地区相比，卫生系统,和耳鼻喉科诊所人口统计学。
■在38,461名被诊断为中耳炎（OM）的儿童中，有61.4％是白人，27.4%是黑人，32.7%有私人保险，18.2%是西班牙裔。在小儿耳部看到的患者中，鼻子,和喉部(耳鼻喉科)诊所，70.0%为白色，20.0%为黑色，46.6%有私人保险，14.9%是西班牙裔。在接受鼓膜置管者中发现了进一步的差异：75.6％的白人，15.6%黑色,61.9%的私人保险，和11.7%的西班牙裔。白种人[优势比，OR：1.96，(95%置信区间，CI:1.85-2.04),<.001]和非西班牙裔种族[OR：1.67，（95％CI：1.56-1.75），<.001].地理上,剥夺指数较高的地区的置管率明显较低，白人人口比例较低的地区，和中等收入最低的地区。这些标记与黑人种族和西班牙裔种族密切相关。在剥夺指数较高和收入中位数较低的大多数白人地区，也发现了较低的试管放置率。
■进入儿科耳鼻喉科诊所的比率，以及管子的放置，西班牙裔和黑人种族的儿童明显低于非西班牙裔白人儿童。在白人儿童和有私人保险的儿童中，管子的放置率较高。无论种族人口统计学如何，在SES较低的地区都可以看到较低的置管率。
■回顾性医学回顾和人群水平分析。
■三级转诊中心。
■人口和人口水平特征（年龄，性别,种族,保险状况,和邮政编码)与地区相比，卫生系统,和耳鼻喉科诊所人口统计学。
■在38,461名被诊断为中耳炎（OM）的儿童中，有61.4％是白人，27.4%是黑人，32.7%有私人保险，18.2%是西班牙裔。在小儿耳部看到的患者中，鼻子,和喉部(耳鼻喉科)诊所，70.0%为白色，20.0%为黑色，46.6%有私人保险，14.9%是西班牙裔。在接受鼓膜置管者中发现了进一步的差异：75.6％的白人，15.6%黑色,61.9%的私人保险，和11.7%的西班牙裔。白种人[优势比，OR：1.96，(95%置信区间，CI:1.85-2.04),<.001]和非西班牙裔种族[OR：1.67，（95％CI：1.56-1.75），<.001].地理上,剥夺指数较高的地区的置管率明显较低，白人人口比例较低的地区，和中等收入最低的地区。这些标记与黑人种族和西班牙裔种族密切相关。在剥夺指数较高和收入中位数较低的大多数白人地区，也发现了较低的试管放置率。
■进入儿科耳鼻喉科诊所的比率，以及管子的放置，西班牙裔和黑人种族的儿童明显低于非西班牙裔白人儿童。在白人儿童和有私人保险的儿童中，管子的放置率较高。无论种族人口统计学如何，在SES较低的地区都可以看到较低的置管率。
