National quality evaluation of peri-surgical hearing care for pediatric otitis media with effusion. (15th November 2018) - Jeong, Heon-Jae
Abstract: Objective: Otitis media with effusion (OME) is a common disease among children that can lead to grave sequelae with respect to hearing. Thus, when treating OME, appropriate hearing care should be provided; ventilation tube insertion (VTI), a standard approach for treating OME, is no exception. This study examined hearing care for VTI and its associated factors, especially at the national level. Design: Retrospective database analysis. Setting: Taiwan's National Health Insurance Research Database. Participants: One thousand one hundred and fifty-nine patients who received VTI (age ≤12 years; 2011–12). Intervention: No intervention. Main Outcome Measures: Compliance to guidelines: sufficient observation time (OBS), tympanogram before VTI (TYM-B) and hearing tests before and after VTI (HEAR-B and HEAR-A, respectively). Results: The national proportions of completion for each procedure were 30.1% for OBS, 84.4% for TYM-B, 74.3% for HEAR-B and 36.0% for HEAR-A; those of OBS and HEAR-A were extremely low. Age, nasal allergy and even geographic area were associated with differences across completion patterns. Regression revealed some notable patterns. Compared with non-teaching hospitals, teaching hospitals administered HEAR-B most successfully (odds ratio [OR: 3.20, 95% CI: 1.06–9.63) and the smallest hospital group performed HEAR-B most successfully (OR: 2.92, 95% CI: 1.14–7.46). Conclusion: Several findings surfaced concerning VTI-related hearing care and its association with many clinical and socioeconomic factors in this national study. These findings could serve as a map for improving hearing care quality among children with OME.