The prevalence of racial/ethnic and socioeconomic factors in pressure-equalization tube treatment among preschool-age children with non-syndromic cleft lip/palate in North Carolina

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Catherine L. Cotton (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Robert Mayo

Abstract: The purpose of the current research was to examine the prevalence of middle ear disease, specifically chronic otitis media (OM) in racial/ethnic non-minority (NM) and racial/ethnic minority (REM) children. Previous studies (Fleming-Dutra et al., 2014; Smith & Boss, 2010) have reported Black and Hispanic children were less likely to be diagnosed with OM. In addition, the likelihood of NM and REM children with non-syndromic cleft lip (CL), cleft palate (CP), cleft lip and palate (CLP), being diagnosed with chronic OM and then receiving pressure equalization (PE) tube treatment was investigated. Finally, the use of PE tube treatment in NM and REM children with CL/P based on the expected payer source was explored. The analysis was limited to children birth to five-years, 11-months of age who received medical care in NC as reported to the Healthcare Cost and Utilization Project (HCUP) program during 2016. A total of 319,682 patient files were accessed for the study. Patients with a primary diagnosis of CL/P were identified using ICD-10-CM codes. REM children were under-identified in the diagnosis of chronic OM. The findings of this study were consistent with previous studies by Fleming-Dutra et al., (2014) and Smith and Boss (2010) in which REM children were less likely to be diagnosed with OM compared with NM children. Though not significant, REM children were less likely to be born with CP and CLP. These results are consistent with Canfield et al., (2006) and Williams et al., (2003) who reported rates of oral clefts were higher in NM infants. This study did not identify significant differences in the prevalence of chronic OM, PE tube treatment, or the expected payer source for PE tube treatment for NM and REM children with CL/P. Future studies should continue to investigate what causes delays in seeking or complying with recommendations and how caregivers communicate the frequency and severity of OM symptoms.

Additional Information

Publication
Dissertation
Language: English
Date: 2020
Keywords
Cleft lip and/or palate, Health disparities, North Carolina, Otitis media, Racial/ethnic minorities
Subjects
Otitis media in children $z North Carolina
Cleft lip $z North Carolina
Cleft palate $z North Carolina
Discrimination in medical care $z North Carolina

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