Children from socially disadvantaged backgrounds are less likely to receive treatment for otitis media and more likely to experience complications from undertreatment, according to a study published in JAMA Otolaryngology-Head & Neck Surgery. To quantify social disparities in treatment patterns, Z. Jason Qian, MD, and colleagues used insurance claims data with linked inpatient, outpatient, and pharmaceutical claims for 4.8 million US children with otitis media. In total, 20.59% were treated for recurrent otitis media, 14.86% were treated for suppurative otitis media, 6.95% received tympanostomy tubes, and 0.23% were treated for severe complications. Earlier age at diagnosis, male sex, environmental allergies, gastroesophageal reflux, and adenotonsillar hyperplasia were all associated with increased treatment for otitis media, when adjusting for patient factors and social indices. Social deprivation was associated with lower odds of medical treatment for recurrent otitis media (OR, 0.86), suppurative otitis media (OR, 0.61), and tympanostomy tubes (OR, 0.76), as well as higher odds of treatment for severe complications of undertreated otitis media (OR, 1.28).
