Sociodemographic Factors and Health Care Utilization in Pediatric Chronic Suppurative Otitis Media

William C. Ruffin, Jacob B. Crouch, Clayton P. Burruss, Matthew L. Bush

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: Access to and utilization of perioperative healthcare may influence outcomes in patients with chronic suppurative otitis media (CSOM); however, the influencing factors are poorly understood. The objective of this study was to assess the association of sociodemographic factors with perioperative health care utilization for pediatric CSOM patients. Methods: We conducted a review on pediatric CSOM patients (≤18 years old) who underwent tympanoplasty with/without mastoidectomy between 2010 and 2020. Sociodemographic data and clinical were collected on all participants. Univariate and multivariate logistic regression analysis was conducted to assess the association between these factors and perioperative care utilization. Results: 427 patients were included in the study. The primary factor associated with health care utilization was insurance status. Rural children were more likely to have Medicaid insurance (p = 0.048). For tympanoplasty patients, Medicaid patients have 1.66 higher odds of pre-operative no-shows (p = 0.01), 1.31 higher odds of post-operative no-shows (p = 0.02), and 59% lower odds of having a postoperative audiogram (p = 0.01), and 2.64 higher odds of being from a rural community (p = 0.02). For patients undergoing mastoidectomy, Medicaid patients have 1.25 higher odds of postoperative no-shows (p = 0.01), 39% lower odds of having a revision procedure for ossicular reconstruction (p = 0.045). Appalachian rural mastoidectomy patients had 3.62 higher odds of having cholesteatoma (p = 0.05). Conclusion: Pediatric patients with CSOM who have Medicaid insurance, especially those who reside in rural regions, are at risk for lower perioperative hearing health care utilization. As these findings may impact care delivery and clinical outcomes, efforts should be focused on promoting utilization among these populations. Level of Evidence: 4 Laryngoscope, 133:700–705, 2023.

Original languageEnglish
Pages (from-to)700-705
Number of pages6
Issue number3
StatePublished - Mar 2023

Bibliographical note

Funding Information:
The funding organizations had no input into the content of this manuscript. M.L.B. is a consultant for MED‐EL and Stryker and has received research funding from Advanced Bionics (unrelated to this research). There are no conflicts of interests with the content of this manuscript. The authors have no other financial relationships or conflicts of interest to disclose pertaining to the manuscript.

Publisher Copyright:
© 2022 The American Laryngological, Rhinological and Otological Society, Inc.


  • chronic suppurative otitis media
  • health care utilization
  • tympanomastoidectomy
  • tympanoplasty

ASJC Scopus subject areas

  • Otorhinolaryngology


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