Australian Aboriginal children have higher hospitalization rates for otitis media but lower surgical procedures than non-Aboriginal children: A record linkage population-based cohort study

Westphal, Darren W; Lehmann, Deborah; Williams, Stephanie; Richmond, Peter; Lannigan, Francis J.; Fathima, Parveen; Blyth, Christopher C; Moore, Hannah C

doi:10.1371/journal.pone.0215483

Cited by 9 publications

(18 citation statements)

References 22 publications

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“…It is possible that some ICD-10-AM codes used to identify OM may be indicative of other disease (e.g., perforation of the tympanic membrane), which may have biased our measure. However, the codes we used are consistent with other published research, the authors of which consulted with ear specialists in defining their inclusion criteria [3]. In addition, OM is primarily managed in the community by general practitioners.…”

Section: Discussionmentioning

confidence: 82%

“…Tympanostomy tube insertion is effective in preventing repeated episodes of OM [38], which is important due to the association of repeated or persistent OM with hearing loss [6]. However, surgical treatment of OM is less frequently performed for Aboriginal children, despite higher prevalence rates [3]. Antibiotic over-prescription for OM is an issue, but prophylaxis is beneficial for high risk populations, including Aboriginal children [39].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnoses were coded by trained coders using the International Classification of Diseases Tenth Revision, Australian Modification (ICD-10-AM) [20]. As per Westphal et al [3], ICD-10-AM codes H65-67, H70-75, H90.0-H90.2, H90.6-H90.8, H92, and/or H95 were used to identify OM episodes in any of the HMDC primary or additional diagnosis fields.…”

Section: Otitis Media Episodesmentioning

confidence: 99%

“…Otitis media (OM), a spectrum of inflammatory conditions involving the middle ear, is one of the most common conditions affecting young children [1]. Australian Aboriginal and/or Torres Strait Islander children (hereafter, respectfully referred to as Aboriginal) are particularly susceptible to OM [2,3], with the highest reported rates of OM globally [4]. Australian Aboriginal children are five times more likely to be diagnosed with OM in primary care settings than non-Aboriginal children [5], and 10 times more likely to be hospitalized for OM [3].…”

Section: Introductionmentioning

confidence: 99%

“…Australian Aboriginal and/or Torres Strait Islander children (hereafter, respectfully referred to as Aboriginal) are particularly susceptible to OM [2,3], with the highest reported rates of OM globally [4]. Australian Aboriginal children are five times more likely to be diagnosed with OM in primary care settings than non-Aboriginal children [5], and 10 times more likely to be hospitalized for OM [3]. OM is the most common cause of temporary mild-moderate conductive unilateral or bilateral hearing loss in children [1].…”

Section: Introductionmentioning

confidence: 99%

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Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study

Bell

Lima

Lehmann

et al. 2021

IJERPH

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We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Otitis Media Episodesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study

Bell

Lima

Lehmann

et al. 2021

IJERPH

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Association Between Social Disadvantage and Otitis Media Treatment in US Children With Commercial Insurance

Qian

Rehkopf

2023

JAMA Otolaryngol Head Neck Surg

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ImportanceIt is well established that social disadvantage is associated with earlier, more frequent, and more severe otitis media in children. Appropriate medical and surgical treatment of otitis media can prevent hearing loss and other complications, which may affect future academic and employment opportunities in socially disadvantaged populations. Clinical treatment patterns for otitis media in the US are unclear.ObjectiveTo describe and quantify social disparities in the treatment patterns of otitis media in children in the US.Design, Setting, and ParticipantsThis cross-sectional study included claims data from the Optum Clinformatics Data Mart Database between January 1, 2003, and March 31, 2021, with linked inpatient, outpatient, and pharmaceutical claims for 4 831 408 children with otitis media.ExposuresAge at first otitis media diagnosis, sex, environmental allergies, gastroesophageal reflux, adenotonsillar hyperplasia, zip code, social deprivation index score, social vulnerability index score.Main Outcomes and MeasuresTreatment of recurrent and suppurative otitis media in children, insertion of tympanostomy tubes, and treatment for severe complications of undertreated otitis media. The principal measure of social disadvantage was the social deprivation index. The social vulnerability index was used for sensitivity analyses to ensure external validity. Multiple logistic regression analyses were used to quantify the association of all projected variables with the study outcomes.ResultsAmong 4 831 408 US children with otitis media (median [IQR] age, 4 [1-8] years; 2 491 557 boys [51.57%]), 994 921 (20.59%) were treated for recurrent otitis media, 717 978 (14.86%) were treated for suppurative otitis media, 335 949 (6.95%) received tympanostomy tubes, and 10 975 (0.23%) had severe complications of otitis media. In multivariable regression models including patient factors and social indices, earlier age at diagnosis, male sex, environmental allergies, gastroesophageal reflux, and adenotonsillar hyperplasia were associated with increased treatment for otitis media, whereas social deprivation index was associated with lower odds of medical treatment for recurrent otitis media (odds ratio [OR], 0.86; 95% CI, 0.85-0.87), suppurative otitis media (OR, 0.61; 95% CI, 0.60-0.62), and insertion of tympanostomy tubes (OR, 0.76; 95% CI, 0.75-0.78) but higher odds of having severe complications (OR, 1.28; 95% CI, 1.19-1.37).Conclusions and RelevanceThe findings of this cross-sectional study suggest that children with otitis media who were socially disadvantaged were less likely to receive treatment and more likely to experience complications for undertreated otitis media. As otitis media is a modifiable risk factor for hearing loss, efforts need to be made to ensure equitable access to treatment for all children.

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Panel 1: Epidemiology and global health, including child development, sequelae and complications

Gisselsson-Solen,

Gunasekera,

Hall

et al. 2024

International Journal of Pediatric Otorhinolaryngology

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Australian Aboriginal children have higher hospitalization rates for otitis media but lower surgical procedures than non-Aboriginal children: A record linkage population-based cohort study

Cited by 9 publications

References 22 publications

Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study

Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study

Association Between Social Disadvantage and Otitis Media Treatment in US Children With Commercial Insurance

Panel 1: Epidemiology and global health, including child development, sequelae and complications

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