Factors affecting clinic attendance for children referred with middle ear conditions
Holly McLaren1, Raymond Kim1, Wiremu MacFater1
1Department of Surgery, The University of Auckland, Auckland, New Zealand.
Insights
Ethnic inequities in pediatric middle ear disease care exist. Māori and Pasifika children face delayed referrals and higher no-show rates for audiology appointments, indicating disparities in access to care.
Area of Science:
- Otolaryngology
- Pediatric Health
- Health Equity
Background:
- Middle ear disease is a prevalent childhood condition with potential long-term complications if not treated.
- Inequities in healthcare access and outcomes based on ethnicity and socioeconomic status are a concern in pediatric care.
Purpose of the Study:
- To investigate ethnic and socioeconomic disparities among children referred to a tertiary regional pediatric Otolaryngology (ORL) service for middle ear disease.
- To analyze referral timing and appointment attendance rates across different ethnic and socioeconomic groups.
Main Methods:
- A retrospective review of all middle ear pathology referrals to Starship Children's Hospital ORL service (2018-2019).
- Collection of demographic data and appointment outcomes from online clinical records.
- Statistical analysis of relationships between ethnicity, socioeconomic status, age at referral, and clinic attendance.
Main Results:
- Out of 1530 referrals, 214 (14.0%) did not attend appointments.
- Māori children were referred 1.1 years later, and Pasifika children 2.4 years later than European children.
- Māori children were 4.3 times, and Pasifika children 7.2 times more likely to miss appointments.
- Socioeconomic status did not significantly impact referral age or attendance.
Conclusions:
- Māori and Pasifika children with middle ear disease experience delayed referrals and higher rates of missed outpatient appointments.
- These findings highlight significant ethnic inequities in accessing pediatric audiology services, with Pasifika children facing greater challenges.
Background:
Middle ear disease is common in children and, if untreated, can lead to long term complications. This study investigated whether ethnic or socioeconomic inequities existed among children referred to a tertiary regional paediatric ORL service.
Methods:
All middle ear pathology related referrals to Starship Children's Hospital ORL service during 2018 and 2019 were reviewed. Online clinical records were accessed to collect demographic data and appointment outcomes. The relationships between ethnicity, socioeconomic status, age at referral and clinic attendance were analysed.
Results:
A total of 1530 children were referred and 214 (14.0%) of these did not attend their scheduled appointments. Compared with the age of referral for European children, Māori children were referred on average 1.1 years older while Pasifika children were referred 2.4 years older. Compared to European children, Māori children were 4.3 times more likely to miss an appointment while Pasifika were 7.2 times more likely. Socioeconomic status had no significant effect on either age of referral or clinic attendance.
Conclusions:
Māori and Pasifika children with middle ear disease are referred later and are more likely to miss outpatient clinic appointments. Pasifika children are affected more than Māori.
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