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Socioeconomic status significantly influences the outcomes of adenotonsillectomy procedures, with privately insured patients having lower rates of preoperative moderate-to-severe obstructive sleep apnea and postoperative admissions, but higher rates of follow-up phone calls and visits.

The following is a summary of “Socioeconomic status is associated with pediatric adenotonsillectomy outcomes: A single institution study,” published in the December 2023 issue of Pediatrics by Fenton et al.

In the institution, catering to a diverse patient demographic within a metropolitan area, existing literature has illuminated a concerning trend: pediatric otolaryngology patients from lower socioeconomic backgrounds often face heightened rates of sleep-disordered breathing, encounter delays in receiving treatment, and exhibit increased risks of complications following tonsillectomy. Against this backdrop, this study seeks to comprehensively investigate the impact of socioeconomic status (SES) on the outcomes of adenotonsillectomy procedures performed within their institution.

Assessing various outcome parameters such as postoperative hospital admissions, post-surgery phone calls, 30-day follow-up, and persistent obstructive sleep apnea (OSA), this study employed descriptive statistical analyses using Wilcoxon Signed Rank Tests. Additionally, it employed univariate and multivariate logistic regression modeling techniques to identify statistically significant covariates, considering an alpha value of α = 0.05.

The study cohort encompassed a demographic distribution comprising Non-Hispanic White (n = 488, 31 %), Non-Hispanic Black (n = 801, 51 %), Hispanic (n = 210, 13 %), and other (n = 61, 4 %) groups. Through multivariate regression analysis, it was revealed that privately insured patients exhibited a lower likelihood of presenting with moderate-to-severe OSA before surgery (0.65, 95 % CI 0.45, 0.93, p = 0.017) and being admitted postoperatively (0.73, 0.55–0.96, p < 0.01). However, they were more likely to receive 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). Furthermore, increased income levels correlated with reduced rehospitalizations within three months post-surgery (0.98, 0.97–1.00, p < 0.01).

This study underscores the considerable impact of socioeconomic status on the outcomes of adenotonsillectomy procedures. The findings advocate for further investigations to better tailor healthcare interventions for the entire spectrum of pediatric patients, emphasizing the need for equitable care across diverse socioeconomic backgrounds.

Source: sciencedirect.com/science/article/abs/pii/S0165587623004111