Back to Search
Start Over
Rural Barriers to Surgical Care for Children With Sleep-Disordered Breathing.
- Source :
- Otolaryngology-Head & Neck Surgery; Jun2022, Vol. 166 Issue 6, p1127-1133, 7p
- Publication Year :
- 2022
-
Abstract
- Objective: To assess the impact of rural-urban residence on children with obstructive sleep-disordered breathing (SDB) who were candidates for tonsillectomy with or without adenoidectomy (TA). Study Design: Retrospective cohort study. Setting: Tertiary children's hospital. Methods: A cohort of otherwise healthy children aged 2 to 18 years with a diagnosis of obstructive SDB between April 2016 and December 2018 who were recommended TA were included. Rural-urban designation was defined by ZIP code approximation of rural-urban commuting area codes. The main outcome was association of rurality with time to TA and loss to follow-up using Cox and logistic regression analyses. Results: In total, 213 patients were included (mean age 6 ± 2.9 years, 117 [55%] male, 69 [32%] rural dwelling). Rural-dwelling children were more often insured by Medicaid than private insurance (P <.001) and had a median driving distance of 74.8 vs 16.8 miles (P <.001) compared to urban-dwelling patients. The majority (94.9%) eventually underwent recommended TA once evaluated by an otolaryngologist. Multivariable logistic regression analysis did not reveal any significant predictors for loss to follow-up in receiving TA. Cox regression analysis that adjusted for age, sex, insurance, and race showed that rural-dwelling patients had a 30% reduction in receipt of TA over time as compared to urban-dwelling patients (hazard ratio, 0.7; 95% CI, 0.50-0.99). Conclusion: Rural-dwelling patients experienced longer wait times and driving distance to TA. This study suggests that rurality should be considered a potential barrier to surgical intervention and highlights the need to further investigate geographic access as an important determinant of care in pediatric SDB. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01945998
- Volume :
- 166
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Otolaryngology-Head & Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 157223991
- Full Text :
- https://doi.org/10.1177/0194599821993383