title: Healthcare disparities in revisits for complications after adult tonsillectomy.
abstract: OBJECTIVE
  Determine if disparities exist for revisit complications after adult tonsillectomy.
  
  
  METHODS
  Cases of adult tonsillectomy were extracted from the state ambulatory surgery databases and linked to the state emergency department databases and inpatient databases for California, Iowa, Florida and New York for 2010 and 2011. Revisits within 14days for diagnoses of: post-tonsillectomy bleeding, acute pain and nausea/vomiting/dehydration were determined and analyzed for associations of these complications with age, sex, race, median household income and comorbidity score.
  
  
  RESULTS
  Among 17,836 tonsillectomies (63.7% female; mean age, 29.0years), revisit rates for post-tonsillectomy bleeding, acute pain and fever/dehydration were 5.1, 2.8 and 1.5%, respectively. On multivariate analysis, only female sex was associated with a lower post-tonsillectomy bleeding rate (odds, 0.48, p<0.001). Decreasing household income, female sex, black and Hispanic race were associated with increased revisits for acute pain (odds, 1.21, 1.49, 2.03 and 1.32, p≤0.002). Female sex was associated with an increased odds of a revisit for FNVD (odds, 1.94, p<0.001).
  
  
  CONCLUSIONS
  Significant disparities with respect to income and race exist in the incidence of revisits and potentially avoidable complications after adult tonsillectomy.
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA. Electronic address: neiloy@massmed.org.
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D002140:California; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D005500:Follow-Up Studies; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D007484:Iowa; D008297:Male; D009518:New York; D010149:Postoperative Pain / Q000453:epidemiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult