ASPO097 - The Role of Socioeconomic Factors in Length of Stay and Hospital Charges Following Pediatric Mastoidectomy
Sunday, May 1, 2022
11:20 AM – 12:00 PM CT
Location: Landmark B
Karandeep S. Randhawa, BS1, Avneet Randhawa, BS1, Prayag Patel, MD1, Christina H. Fang, MD2, Jean A. Eloy, MD, FACS1;
1Department of Otolarygology - Head and Neck Surgery, New Jersey Med. Sch., Newark, NJ, 2Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein Coll. of Med., Bronx, NY
Introduction: Socioeconomic disparities in postoperative outcomes have previously been observed in multiple head and neck procedures but have not yet been described in mastoidectomy. This study aimed to analyze the impact of race, income, and insurance payer on outcomes following mastoidectomy in pediatric populations.
Methods: This analysis utilized the 2003 to 2014 National Inpatient Sample database. Patients under 18 years old with a primary inpatient procedure of mastoidectomy were queried. High total charges and prolonged length of stay (LOS) were indicated by values greater than the 90th percentile of the overall sample. This analysis utilized chi square, ANOVA, and binary logistic regression.
Results: 3,142 weighted cases were included. Black, Hispanic, and Asian patients had significantly greater mean LOS (5.5, 6.6, and 6.7 days, respectively) and hospital charges ($52,270, $55,727, and $40,365 dollars, respectively) compared to White patients (4.2 days, p<0.001; $37,847, p=0.041). Mean LOS and charges in Medicaid (5.7 days, $47,984) and uninsured (5.29 days, $46,084) patients were higher than those with private insurance (4.23 days, p=0.026; $36,900, p=0.027). After adjusting for demographic/hospital characteristics and comorbidities, multivariate analysis found that Black and Hispanic patients were more likely than White patients to experience prolonged LOS (Black: OR 2.176 95% CI 1.301-3.642, p=0.003; Hispanic: OR 2.438 95% CI 1.622-3.663, p<0.001). Black and Hispanic patients also experienced increased odds of high hospital charges (Black: OR 2.406 95% CI 1.499-3.862, p<0.001, Hispanic: OR 1.948 95% CI 1.232-3.078, p=0.005).
Conclusion: In pediatric inpatients undergoing mastoidectomy, several socioeconomic factors were identified to be associated with poorer outcomes. Black and Hispanic pediatric patients in this cohort were more likely to face increased hospital charges and LOS.