title: Decreasing rates of middle ear surgery in Western Australian children.
abstract: OBJECTIVE
  To investigate temporal, social, demographic, and health care utilization factors associated with myringotomy with ventilation tube insertion (MVTI) in Western Australian (WA) children.
  
  
  METHODS
  Observational retrospective population-based cohort study using hospital administrative data.
  
  
  METHODS
  All WA hospitals.
  
  
  METHODS
  A total of 53 673 children younger than 15 years who underwent surgery for MVTI in the period 1981-2004.
  
  
  METHODS
  Age-specific incidence rates and incidence rate ratios.
  
  
  RESULTS
  The rate of MVTI in children younger than 15 years peaked in 1997 at 6.7 per 1000 person-years and decreased to 5.6 per 1000 person-years by 2004. Based on 2004 rates, 8.4% of WA children will undergo at least 1 MVTI procedure before reaching age 15 years. The rate of MVTI was 37% lower in Indigenous children, and the procedures were performed at an older age compared with non-Indigenous children. Higher rates of MVTI were associated with areas of higher economic resources, lower education and occupation status, and living in metropolitan areas.
  
  
  CONCLUSIONS
  The rate of MVTI in WA is showing evidence of a decline, even among children younger than 5 years. There remains an issue regarding equity of access to care for Indigenous children. Increasing parental economic resources may be associated with higher rates of MVTI independent of educational status.
authors.affiliation: Centre for Health Services Research, School of Population Health, University of Western Australia, Perth, Australia. K.Spilsbury@curtin.edu.au
authors.forename: Katrina
authors.initials: K
authors.lastname: Spilsbury
authors.forename: Abdul Latif
authors.initials: AL
authors.lastname: Kadhim
authors.forename: James B
authors.initials: JB
authors.lastname: Semmens
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Lannigan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000191:economics / Q000706:statistics & numerical data*; D010033:Otitis Media / Q000601:surgery; D012189:Retrospective Studies; D014904:Western Australia