Socioeconomic status is associated with pediatric adenotonsillectomy outcomes: A single institution study

Abstract

ObjectiveOur institution serves a diverse patient population across a large metropolitan city. Literature has shown pediatric otolaryngology patients with lower socioeconomic status (SES) have higher rates of sleep-disordered breathing, delays in treatment time, and greater risks of complications post-tonsillectomy. This study aims to examine the effects of SES on adenotonsillectomy outcomes performed at our institution. Study designA retrospective chart review including 1560 pediatric patients (ages 0–18) who underwent adenotonsillectomy between January 2015 and December 2020. SettingLarge metropolitan hospital, level 1 trauma center. MethodsOutcome variables included postoperative hospital admission, phone calls, 30-day follow-up, and persistent obstructive sleep apnea (OSA). Descriptive statistics using Wilcoxon Signed Rank Tests and univariate and multivariate logistic regression modeling were used to determine statistically significant covariates at α = 0.05. ResultsThe cohort included Non-Hispanic White (n = 488, 31 %), Non-Hispanic Black (n = 801, 51 %), Hispanic (n = 210, 13 %), and other (n = 61, 4 %) groups. Using multivariate regression, privately insured patients were less likely to have moderate-to-severe OSA before surgery (0.65 95 % CI 0.45, 0.93 p = 0.017) and be admitted postoperatively (0.73, 0.55–0.96, p < 0.01), while more likely to have postoperative follow-up phone calls (1.57, 1.19–2.09, p < 0.01) and visits (1.53, 1.22–1.92, p < 0.01). Increased income was associated with decreased rehospitalizations within three months of surgery (0.98, 0.97–1.00, p < 0.01). ConclusionThis study suggests SES significantly affects adenotonsillectomy outcomes. Further studies are warranted to provide better care for all pediatric patients.