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Access to care for children with symptoms of sleep disordered breathing
Edward B Penn1, Adam French, Bharat Bhushan
1Department of Pediatric Surgery, Children's Memorial Hospital, Chicago, IL, USA.
Insights
Children with Medicaid insurance face longer wait times and travel farther for otolaryngologist appointments for sleep disordered breathing (SDB) compared to those with private insurance.
Area of Science:
- Pediatric Otolaryngology
- Healthcare Access
- Sleep Medicine
Background:
- Sleep disordered breathing (SDB) affects children, necessitating timely specialist care.
- Access to otolaryngologists can be influenced by insurance type.
- Disparities in healthcare access may impact pediatric SDB management.
Purpose of the Study:
- To compare access to otolaryngologists for children with SDB based on insurance status.
- To investigate potential differences in appointment wait times and travel distances between Medicaid and privately insured children.
Main Methods:
- Retrospective study involving children referred for SDB evaluation.
- Data collected via parent/guardian surveys at a tertiary care pediatric hospital.
- Main outcome measures included timely access and travel distance to otolaryngologists.
Main Results:
- Children with Medicaid (n=47) experienced significantly longer wait times (10.8 weeks) compared to privately insured children (n=50) (1.97 weeks).
- Medicaid-insured children traveled farther (18.05 miles) for appointments than privately insured children (9.86 miles).
- Patient demographics and SDB symptoms were similar across insurance groups.
Conclusions:
- Insurance type significantly impacts access to otolaryngology care for pediatric SDB.
- Children with Medicaid face substantial delays and increased travel burden for specialist appointments.
- Addressing these access barriers is crucial for equitable SDB management in children.
Objectives:
To determine if children with sleep disordered breathing who have Medicaid insurance encounter more difficulty accessing an otolaryngologist than those with private insurance.
Design:
Retrospective study.
Setting:
Urban tertiary care pediatric hospital.
Patients:
Children referred for evaluation of sleep disordered breathing (SDB).
Intervention:
Survey of patients' parents and guardians.
Main Outcome Measure:
Timely access to an otolaryngologist in their community.
Results:
Ninety-seven patients were included. Fifty patients had private insurance, 47 had Medicaid. The mean age was 5 years for those with private insurance and 5.6 years for those with Medicaid (p=0.27). The symptoms of SDB in both groups were similar. It took an average of 1.97 weeks for the children in the private insurance group to get an appointment versus 10.8 weeks for those with Medicaid (p=0.002). The mean distance traveled by the children in the private insurance group was 9.86 miles compared to 18.05 miles for those with Medicaid (p=0.001).
Conclusion:
Children who were referred for evaluation of SDB were of similar age and had similar symptoms regardless of insurance type. Children with Medicaid wait longer and travel farther to see an otolaryngologist than children with private insurance.
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