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Decreasing rates of middle ear surgery in Western Australian children
Katrina Spilsbury1, Abdul Latif Kadhim, James B Semmens
1Centre for Health Services Research, School of Population Health, University of Western Australia, Perth, Australia. K.Spilsbury@curtin.edu.au
Insights
Myringotomy with ventilation tube insertion (MVTI) rates in Western Australian children are declining, but Indigenous children face access barriers. Higher socioeconomic status may correlate with increased MVTI procedures.
Area of Science:
- Pediatric Otolaryngology
- Public Health Research
- Health Services Research
Background:
- Myringotomy with ventilation tube insertion (MVTI) is a common pediatric surgical procedure.
- Understanding factors influencing MVTI rates is crucial for public health planning and equitable healthcare delivery.
Purpose of the Study:
- To examine temporal trends, social, demographic, and healthcare utilization factors associated with MVTI in Western Australian children.
- To identify disparities in MVTI access among different child populations.
Main Methods:
- Retrospective population-based cohort study utilizing hospital administrative data from Western Australia.
- Analysis of 53,673 children younger than 15 years undergoing MVTI between 1981 and 2004.
- Calculation of age-specific incidence rates and incidence rate ratios to assess trends and associations.
Main Results:
- MVTI rates peaked in 1997 and showed a subsequent decline, with 8.4% of children projected to undergo the procedure before age 15.
- Indigenous children had a 37% lower rate of MVTI and underwent the procedure at an older age compared to non-Indigenous children.
- Higher MVTI rates were observed in areas with greater economic resources, lower education/occupation status, and in metropolitan regions.
Conclusions:
- MVTI rates in Western Australia are decreasing, including for young children.
- Significant equity issues persist regarding access to MVTI for Indigenous children.
- Increased parental economic resources may be linked to higher MVTI rates, irrespective of educational background.
Objective:
To investigate temporal, social, demographic, and health care utilization factors associated with myringotomy with ventilation tube insertion (MVTI) in Western Australian (WA) children.
Design:
Observational retrospective population-based cohort study using hospital administrative data.
Setting:
All WA hospitals.
Participants:
A total of 53 673 children younger than 15 years who underwent surgery for MVTI in the period 1981-2004.
Main Outcome Measures:
Age-specific incidence rates and incidence rate ratios.
Results:
The rate of MVTI in children younger than 15 years peaked in 1997 at 6.7 per 1000 person-years and decreased to 5.6 per 1000 person-years by 2004. Based on 2004 rates, 8.4% of WA children will undergo at least 1 MVTI procedure before reaching age 15 years. The rate of MVTI was 37% lower in Indigenous children, and the procedures were performed at an older age compared with non-Indigenous children. Higher rates of MVTI were associated with areas of higher economic resources, lower education and occupation status, and living in metropolitan areas.
Conclusions:
The rate of MVTI in WA is showing evidence of a decline, even among children younger than 5 years. There remains an issue regarding equity of access to care for Indigenous children. Increasing parental economic resources may be associated with higher rates of MVTI independent of educational status.
