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Contemporary Sociodemographic Disparities in Tracheostomy Timing and Resource Utilization
Henry Diamond-Pott1, Larissa Iraj1, Aditi Doiphode1
1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
The Laryngoscope
|August 11, 2026
Summary
Racial disparities in tracheostomy outcomes persist, with Black and Hispanic patients experiencing longer hospital stays and increased costs. These inequities, particularly for Hispanic patients, highlight ongoing challenges in airway management.
Area of Science:
- Health Services Research
- Health Equity
- Surgical Outcomes
Background:
- Tracheostomy outcomes show documented racial disparities.
- Contemporary national trends in tracheostomy timing and resource use are not well understood.
- Healthcare systems faced significant strain from 2018-2022.
Purpose of the Study:
- To evaluate racial differences in tracheostomy outcomes.
- To analyze national trends in tracheostomy timing and resource utilization from 2018-2022.
- To assess disparities during a period of healthcare system strain.
Main Methods:
- Retrospective cohort study using the Healthcare Cost and Utilization Project National Inpatient Sample (2018-2022).
- Included adult patients undergoing tracheostomy.
- Analyzed length of stay (LOS), total hospital charges, in-hospital mortality, and time from admission to tracheostomy.
- Used multivariable regression to adjust for patient, hospital, and procedural factors.
Main Results:
- Across 488,745 admissions, LOS, charges, and time to tracheostomy increased over time for all racial groups (p < 0.001).
- Black and Hispanic patients had longer LOS (+2.26 and +2.94 days, respectively) and longer admission-to-tracheostomy intervals (+0.73 and +1.06 days, respectively) compared to White patients (p < 0.01).
- Disparities remained stable for Black patients but widened for Hispanic patients. In-hospital mortality was lower for Black patients (OR: 0.93) and higher for Hispanic patients (OR: 1.12).
Conclusions:
- Persistent racial disparities in tracheostomy timing and resource utilization exist.
- Widening inequities were observed among Hispanic patients.
- Further evaluation of factors influencing airway management is warranted to address these disparities.