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Published on: November 6, 2019
Socioeconomic factors associated with readmission following pediatric tonsillectomy
Ashley M Lloyd1, Hengameh K Behzadpour2, Ian Schonman3
1Division of Otolaryngology, George Washington University Hospital, Washington, DC, USA.
Insights
Pediatric tonsillectomy readmissions are linked to age and socioeconomic factors. Older children face higher risks, while lower poverty and higher parental education correlate with fewer readmissions.
Area of Science:
- Pediatric Otolaryngology
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Readmission after tonsillectomy can be due to bleeding, pain, or dehydration.
- Understanding readmission factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze factors associated with readmission after pediatric tonsillectomy.
- To investigate the role of socioeconomic factors in tonsillectomy readmissions.
Main Methods:
- Retrospective study of 14,152 pediatric patients undergoing tonsillectomy.
- Comparison of readmitted patients (for bleeding, pain/dehydration) versus non-readmitted patients.
- Multivariate analysis to identify significant predictors of readmission.
Main Results:
- Overall readmission rate was 3.6% (508 patients).
- Increased readmission risk observed in children over 6 years old (OR: 1.61).
- Lower poverty (<10%) and higher parental college education (>25%) were associated with decreased readmission (OR: 0.79 for both).
- Age >6 years predicted bleeding-related readmissions (OR: 1.66).
- African American race linked to higher pain/dehydration readmissions; lower poverty and higher parental education linked to lower readmissions in this group.
Conclusions:
- Socioeconomic factors significantly influence readmission rates after pediatric tonsillectomy.
- Age is a key factor, with older children experiencing higher readmission risks.
- Targeted interventions addressing socioeconomic disparities may reduce pediatric tonsillectomy readmissions.
Objectives:
We aim to analyze factors associated with readmission after tonsillectomy to understand socioeconomic factors associated with readmission.
Methods:
Single institution retrospective study of pediatric patients undergoing tonsillectomy over an 8 year study period, comparing patients who required readmission for bleeding concerns or pain/dehydration to those who did not require readmission.
Results:
Of the 14,152 tonsillectomy patients, 508 (3.6%) were readmitted with 423 (83.3%) for bleeding concerns and 85 (16.7%) for pain or dehydration. Overall readmission was more likely in age >6 years (OR: 1.61, 95% CI: 1.34-1.92, P < 0.001), while poverty level below 10% (OR: 0.79, 95% CI: 0.66-0.94, P = 0.008) and parental college education above 25% (OR: 0.79, 95% CI: 0.65-0.96, P = 0.016) were associated with lower incidence of overall readmission. For patients readmitted for bleeding concerns, age >6 years (OR 1.66, 95% CI: 1.37-2.02, P < 0.001) was associated with readmission on multivariate analysis. Within the pain/dehydration group, African American race was associated with increased readmission rates, while poverty level below 10% and parental college education above 25% were associated with decreased readmission rates.
Conclusion:
Socioeconomic factors and age play a role in readmission rates following pediatric tonsillectomy.
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