Effect of Insurance Type on Postoperative Tympanostomy Tube Follow Up

Children who experience recurrent otitis media — also known as a middle ear infection — often undergo a procedure called bilateral myringotomy with tube insertion (BMT) to reduce the occurrence of infection. 

In this procedure, a small opening is made in each eardrum and a small tube is placed in the opening on each side. The tube allows for fluid inside the ear to flow out or dry up, which alleviates the pain and pressure patients feel while also making future infections less likely.

As with many surgical procedures, BMT requires appropriate follow-up care to ensure quality management of any postoperative effects.

A team of UPMC and Pitt experts recently conducted a study to examine the relationship between insurance type and postoperative follow-up appointment attendance. The team also analyzed whether attendance to follow-up appointments affected the need for further care following BMT.

The study included 734 patients who were younger than three years old and underwent BMT, with the mean patient age being 1.4 years old. Data from study participants was collected for three years following the procedure. 

The number of follow-up appointments attended as well as patient demographics, socioeconomic status, and postoperative outcomes were analyzed.

Results showed that 70.8% of patients had private insurance. These individuals were more likely to attend postoperative appointments and less likely to have BMT-related emergency department visits. 

Contrastingly, the 29.2% of patients with public insurance attended fewer postoperative appointments and had a higher incidence of BMT-related emergency department visits.

Therefore, it was determined that insurance type is related to patient outcomes after the treatment of recurrent ear infections with BMT. 

Authors concluded that earlier interventions, counseling, and the use of telemedicine may benefit patients within the public insurance group and reduce barriers that prevent them from receiving proper follow-up care. 

Reference

Patel TA, McCoy JL, Belsky MA, Sim ES, Konanur A, Yan A, Jabbour N, Padia R. Effect of Insurance Type on Postoperative Tympanostomy Tube Follow-up. Otolaryngol Head Neck Surg. 2021 Dec 28:1945998211067504. doi: 10.1177/01945998211067504. Epub ahead of print. PMID: 34962848.