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Decreasing Rates of Middle Ear Surgery in Western Australian Children
Katrina Spilsbury, PhD;
Abdul Latif Kadhim, FRCSI;
James B. Semmens, PhD;
Francis J. Lannigan, FRACS, FRCS(ORL)
Arch Otolaryngol Head Neck Surg. 2006;132:1216-1220.
Objective To investigate temporal, social, demographic, and health care utilization factors associated with myringotomy with ventilation tube insertion (MVTI) in Western Australian (WA) children.
Design Observational retrospective population-based cohort study using hospital administrative data.
Setting All WA hospitals.
Participants A total of 53 673 children younger than 15 years who underwent surgery for MVTI in the period 1981-2004.
Main Outcome Measures 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.
Author Affiliations: Centre for Health Services Research, School of Population Health, University of Western Australia, Perth, Australia (Drs Spilsbury and Semmens); and Department of Paediatric Otolaryngology, Princess Margaret Hospital, Perth (Drs Kadhim and Lannigan). Drs Spilsbury and Semmens are now at the School of Public Health, Curtin University of Technology, Perth.
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