Measuring the Impact of a Delay in Care on Pediatric Otolaryngologic Surgery Completion

• Type of Material: Article
• Authors: Geethanjeli N. Mahendran, Emory University; Ching Siong Tey, Emory University; Mary Frances Musso, Baylor College of Medicine; Grace Shebha Anand, Baylor College of Medicine; Jeffrey Larson, Northwestern University Feinberg School of Medicine; Mitesh Mehta, Emory University; Lara Reichert, Ann & Robert H. Lurie Children's Hospital of Chicago; Kara Prickett, Emory University; Nikhila Raol, Emory University
• Language: English
• Date: 2022-01-01
• Publisher: Sage
• Publication Version: Final Published Version
• Copyright Statement: © 2022, © SAGE Publications
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/01455613221134428
• Title of Journal or Parent Work: Ear, Nose and Throat Journal
• Start Page: 1455613221134428
• End Page: 1455613221134428
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: COVID-19 shutdown; healthcare utilization; pediatric otolaryngology
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Health Care Management

Abstract

Objective: To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression. Methods: We identified patients ≤18 years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients’ rate of and patterns of rescheduling surgery. Surveys were also sent to caregivers to better characterize his/her decision regarding moving forward with his/her child’s surgery during COVID-19. Results: A total of 1915 pediatric patients had elective surgeries canceled, of which 992 (51.8%) were rescheduled within 4 months. No difference in rates of rescheduling was identified based on race or ethnicity. Patients who were scheduled for tonsillectomies and/or adenoidectomies were 1.22 times more likely to reschedule compared to those patients with other planned procedures (CI: 1.02–1.46). A total of 95 caregivers at two hospitals completed surveys: 44 (47.4%) rescheduled their child’s surgery. Most caregivers who rescheduled were concerned their child’s disease could impact their future (n = 14, 32%). Conclusions: Just over half of patients who had pediatric otolaryngologic surgery canceled during a period of social distancing went on to have surgery within a 4-month timeframe. This reflects the dependence of pediatric otolaryngologic surgery on environmental exposures and may represent a potential target for prevention and management of some pediatric otolaryngology diseases.