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Economics Impact Pediatric Sleep-Disordered Breathing Care

Longer intervals from evaluation to polysomnography, sx for kids with public insurance

FRIDAY, Dec. 12, 2014 (HealthDay News) -- Children newly evaluated for sleep-disordered breathing (SDB) with public insurance experience longer intervals from initial evaluation to polysomnography or adenotonsillectomy, according to a study published online Dec. 11 in JAMA Otolaryngology-Head & Neck Surgery.

Emily F. Boss, M.D., M.P.H., from the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a retrospective cohort study to examine the impact of socioeconomic status (SES) on the timing of polysomnography among patients newly evaluated for SDB. The authors used public insurance (Medical Assistance [MA]) as a proxy for low SES. Over the course of three months, 136 children without polysomnography were evaluated for SDB, of whom 45.6 percent had MA.

The researchers found that polysomnography was recommended for 49 and 50 percent of children with MA and private insurance, respectively (P > 0.99). Forty-four percent of children were lost to follow-up after the initial visit. Compared with privately insured children, children with MA who obtained polysomnography had longer intervals between the initial encounter and polysomnography (mean interval, 141.1 versus 49.9 days; P = 0.001). For those children who underwent adenotonsillectomy after polysomnography, the mean time to adenotonsillectomy was 222.3 days for children with MA versus 95.2 days for children with private insurance (P = 0.001).

"This study emphasizes the need to understand factors contributing to disparities surrounding delay in care with polysomnography and surgery for children with SDB," the authors write.

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