Epistaxis health disparities in the United States pediatric population

Area of Science:

• Pediatric Medicine
• Public Health
• Epidemiology

Background:

• Epistaxis affects up to 60% of the population, yet pediatric health disparities in epistaxis care are understudied.
• Understanding sociodemographic factors is crucial for addressing variations in healthcare access and outcomes for pediatric epistaxis.

Purpose of the Study:

• To investigate sociodemographic risk factors associated with emergency department visits for epistaxis in children.
• To identify disparities in healthcare utilization for pediatric epistaxis.

Main Methods:

• Analysis of data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey Outpatient Department (2001-2010).
• Inclusion of outpatient visits for children under 18 with a primary, secondary, or tertiary diagnosis of epistaxis (ICD-9CM code 784.7X).
• Application of bivariate and stepwise multivariate regression analyses to identify significant sociodemographic predictors.

Main Results:

• Epistaxis accounted for approximately 5 million pediatric outpatient visits.
• Children with private insurance and Medicaid represented 51% and 33% of visits, respectively.
• Black children were more likely to present with epistaxis compared to white children (95% CI 1.3-4.1).
• Older age was associated with increased epistaxis visits (p=0.006).
• Allergic rhinitis was a significant comorbidity (95% CI 1.3-4.6).
• Visits were more likely to occur in pediatric clinics (69%) and ENT/surgery clinics (18%) compared to general/family medicine clinics.

Conclusions:

• Pediatric epistaxis visits are significantly associated with patient age, race, and the specialty of the healthcare provider.
• The findings highlight the need for developing targeted interventions to mitigate disparities and improve care for pediatric epistaxis.