Nationwide disparities in transportation related delays to care experienced by children with frequent ear infections

Abstract

BackgroundAcute otitis media (AOM), or ear infection, is the most common reason for pediatric medical visits in the United States [1]. Additionally, transportation barriers are a significant driver of missed and delayed care across medical specialties [2,3]. Yet, the role of transportation barriers in impeding access for children with frequent ear infections (FEI) has not been investigated. Assessing the prevalence of transportation barriers across sociodemographic groups may help clinicians improve outcomes for children with FEI. MethodsA retrospective analysis of the U.S. National Health Interview Survey was completed to examine associations between sociodemographic characteristics among children with FEI and transportations barriers to seeking care between 2011 and 2018. ResultsMultivariable logistic regression found that income level, insurance status, and health status were linked to disparities in transportation barriers among children with FEI. Those in the middle (aOR 3.00, 95% CI 1.77–5.08, p < 0.001) and lowest income brackets (aOR 6.33, 95% CI 3.80, p < 0.001), who were publicly insured (aOR 3.24, 95% CI 2.00–5.23, p < 0.001) or uninsured (aOR 3.46, 95% CI 1.84–6.51, p < 0.001), and with Poor to Fair health status were more likely to face transportation delays than patients who were in the highest income bracket, privately insured, or had Good to Excellent health status. ConclusionChildren with FEI from families that were lower-income, less insured, and less healthy faced more transportation barriers when accessing care than their counterparts. Future interventions to improve health-related transportation should be targeted toward these patient subgroups to reduce gaps in outcomes.