Factors associated with tympanostomy tube insertion among preschool-aged children in the United States.
OBJECTIVE
Recurrent and persistent otitis media is often treated by tympanostomy tube insertion to ventilate the middle ear and restore hearing. This study examined the factors that predict which children are most likely to receive tympanostomy tubes through 3 years of age.


METHODS
Multiple logistic regression was conducted on data from a nationally representative sample of children (N = 8285).


RESULTS
By 3 years of age, 6.8% of US children had tubes inserted. Logistic regression indicated that after control for number of ear infections, children without any gaps in health insurance, who attended a day-care center, who were White, whose birth-weight was less than 1500 g, and who lived in the Midwest or South were significantly more likely to have tympanostomy tubes.


CONCLUSIONS
These data suggest that differences exist as to who receives tubes. Of particular concern are differences by race/ethnicity and continuity of health insurance coverage. With expansions in health care coverage to larger proportions of uninsured children, it will be important to monitor these programs to ensure that all children who may need tympanostomy tubes have access to them.
Kogan
M D
MD
Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Md., USA. mkogan@hrsa.gov
Overpeck
M D
MD
Hoffman
H J
HJ
Casselbrant
M L
ML
D002675:Child, Preschool; D006801:Humans; D019458:Insurance Coverage; D016015:Logistic Models; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010033:Otitis Media / Q000453:epidemiology / Q000601:surgery*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology