未满足的社会需求对鼓室造瘘置管时机的影响

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-07-06 DOI:10.1016/j.ijporl.2025.112472

Molly O. Meeker , Jemma Maynard , Aidan Vanek , Alexandra Gach , Tatum Adamson , Kolby Quillin , Isaac Kistler , Prasanth Pattisapu , Charles Elmaraghy

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引用次数: 0

摘要

未满足的社会需求（USN）关注个体患者的担忧；与其他健康社会决定因素（SDOH）相比，它们对地理的依赖较小。在这里，我们的目的是表征各种USN对鼓室造瘘管（TT）放置时间的影响。方法回顾性分析我院2023年1月1日至2023年7月1日815例0-4岁首次TT患者的资料。根据电子病历记录患者每次USN的风险。结果我们的研究发现，在存在USN的情况下，高危组（AR）从手术指令到手术时间比非高危组（NAR）长19% (IRR1.19, 95% CI 1.15-1.22,p <；0.01)，经种族和保险因素调整后（R/I）仍然显著(IRR1.15, 95% CI 1.11-1.18,p <；0.01)，种族、保险和临床因素（R/I/C） (IRR1.10, 95% CI 1.07-1.13,p <；0.01)。当评估从最后一次报告耳部感染到耳鼻喉科初步评估的时间时，我们发现对于任何USN， AR组到出现的时间都比NAR组短，在我们调整的R/I和R/I/C模型中效果仍然显著(IRR0.97；95% CI 0.94 ~ 0.99,p = 0.02, IRR0.81；95% CI 0.79-0.83,p <；0.01和IRR0.70；95% CI 0.68-0.73,p <；分别为0.01)。结论本研究表明，任何USN患者从手术指令到手术时间明显长于NAR患者。数据表明，USN和SDOH在护理延迟方面具有微妙和相互依存的关系。这项研究强调了机构可以针对的特定USN，以减轻护理延误。

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Impact of unmet social needs on timing of tympanostomy tube placement

Introduction

Unmet social needs (USN) focus on individual patient concerns; they are less dependent on geography than other social determinants of health (SDOH). Here we aim to characterize the impact of various USN on timing of tympanostomy tube (TT) placement.

Methods

A retrospective chart review of 815 patients 0–4 years old with first-time TT placement at our institution between January 1st, 2023, and July 1st, 2023, was conducted. The risk of each USN were recorded for patients according to the electronic medical record.

Results

Our study found that in the presence of any USN, the at-risk group (AR) had a 19 % longer time between surgery order and surgery than the not-at-risk group (NAR) (IRR1.19, 95 %CI 1.15–1.22,p < 0.01), which remained significant when adjusted for race and insurance (R/I) (IRR1.15, 95 %CI 1.11–1.18,p < 0.01), and race, insurance and clinical factors (R/I/C) (IRR1.10, 95 %CI 1.07–1.13,p < 0.01). When evaluating time from last reported ear infection to initial evaluation by otolaryngology, we found that for any USN, the AR group had a shorter time to presentation than the NAR, with the effect remaining significant in our adjusted models for R/I, and R/I/C (IRR0.97; 95 %CI 0.94–0.99,p = 0.02 and IRR0.81; 95 %CI 0.79–0.83,p < 0.01 and IRR0.70; 95 %CI 0.68–0.73,p < 0.01, respectively).

Conclusions

This study demonstrated that patients with any USN had a significantly longer time from surgery order to surgery than those NAR. The data suggests that USN and SDOH have a nuanced and interdependent relationship regarding delays in care. This study highlights specific USN that institutions can target to mitigate delays in care.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.