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Compliance with recommendations for tympanostomy tube follow-up: patient characteristics.
Otolaryngol Head Neck Surg 2014; 151(3):489-95OH

Abstract

OBJECTIVES

(1) To determine the percentage of otherwise healthy patients achieving "graduation," or postoperative compliance achieving complete problem resolution and discharge from the otolaryngologist's care, after tympanostomy tube placement. (2) To analyze follow-up behaviors and patient characteristics influencing the likelihood of graduation.

STUDY DESIGN

Retrospective cohort study.

SETTING

Tertiary care hospital.

SUBJECTS AND METHODS

Analysis of details of tympanostomy tube placements performed from 2004 to 2011 by 2 pediatric otolaryngologists for children aged 0 to 18 years. Exclusion criteria were clearly defined craniofacial anomalies, cleft palates, and other ongoing postoperative care. The remaining study subjects were categorized into 3 groups. Graduation (GRAD) subjects achieved discharge from care with "follow-up pro re nata" status. LOST<2Y subjects had not attended scheduled follow-up in <2 years. LOST≥2Y subjects had no follow-up in ≥2 years.

RESULTS

A total of 1454 pediatric subjects were included. GRADs constituted only 25.6% of the subject pool; 22.1% were LOST<2Y, and 52.3% were LOST≥2Y. Statistically significant factors in achieving graduation were total number of follow-up visits, total duration of follow-up, compliance with first postoperative visit, patient age, insurance type, and distance between home and practice.

CONCLUSION

Rate of graduation, or postoperative compliance achieving complete problem resolution, of otherwise healthy tympanostomy tube patients is low despite perioperative discussions of the importance of proper follow-up. Higher graduation rates are associated with increasing number of follow-up visits and duration, younger patient age, private insurance, and proximity to the practice. Compliance with attending the first postoperative visit may be an early marker for increased likelihood of graduation.

Authors+Show Affiliations

Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.Wake Forest School of Medicine, Winston-Salem, North Carolina, USA akevans@wakehealth.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24894424

Citation

Kao, Richard, et al. "Compliance With Recommendations for Tympanostomy Tube Follow-up: Patient Characteristics." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 151, no. 3, 2014, pp. 489-95.
Kao R, Kirse DJ, Evans AK. Compliance with recommendations for tympanostomy tube follow-up: patient characteristics. Otolaryngol Head Neck Surg. 2014;151(3):489-95.
Kao, R., Kirse, D. J., & Evans, A. K. (2014). Compliance with recommendations for tympanostomy tube follow-up: patient characteristics. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 151(3), pp. 489-95. doi:10.1177/0194599814537450.
Kao R, Kirse DJ, Evans AK. Compliance With Recommendations for Tympanostomy Tube Follow-up: Patient Characteristics. Otolaryngol Head Neck Surg. 2014;151(3):489-95. PubMed PMID: 24894424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compliance with recommendations for tympanostomy tube follow-up: patient characteristics. AU - Kao,Richard, AU - Kirse,Daniel J, AU - Evans,Adele K, Y1 - 2014/06/03/ PY - 2014/6/5/entrez PY - 2014/6/5/pubmed PY - 2014/11/2/medline KW - otitis media KW - pediatric compliance KW - postoperative care KW - tympanostomy tube SP - 489 EP - 95 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 151 IS - 3 N2 - OBJECTIVES: (1) To determine the percentage of otherwise healthy patients achieving "graduation," or postoperative compliance achieving complete problem resolution and discharge from the otolaryngologist's care, after tympanostomy tube placement. (2) To analyze follow-up behaviors and patient characteristics influencing the likelihood of graduation. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary care hospital. SUBJECTS AND METHODS: Analysis of details of tympanostomy tube placements performed from 2004 to 2011 by 2 pediatric otolaryngologists for children aged 0 to 18 years. Exclusion criteria were clearly defined craniofacial anomalies, cleft palates, and other ongoing postoperative care. The remaining study subjects were categorized into 3 groups. Graduation (GRAD) subjects achieved discharge from care with "follow-up pro re nata" status. LOST<2Y subjects had not attended scheduled follow-up in <2 years. LOST≥2Y subjects had no follow-up in ≥2 years. RESULTS: A total of 1454 pediatric subjects were included. GRADs constituted only 25.6% of the subject pool; 22.1% were LOST<2Y, and 52.3% were LOST≥2Y. Statistically significant factors in achieving graduation were total number of follow-up visits, total duration of follow-up, compliance with first postoperative visit, patient age, insurance type, and distance between home and practice. CONCLUSION: Rate of graduation, or postoperative compliance achieving complete problem resolution, of otherwise healthy tympanostomy tube patients is low despite perioperative discussions of the importance of proper follow-up. Higher graduation rates are associated with increasing number of follow-up visits and duration, younger patient age, private insurance, and proximity to the practice. Compliance with attending the first postoperative visit may be an early marker for increased likelihood of graduation. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/24894424/Compliance_with_recommendations_for_tympanostomy_tube_follow_up:_patient_characteristics_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599814537450?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -