Author(s)
Jonathan M. Bock, MD
Shane W. White, BS
Joel H. Blumin, MD
David R. Friedland, MD PhD
Jazzmyne A. Adams, MPH
Jake Luo, PhD
Affiliation(s)
Medical College of Wisconsin;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to critically evaluate the role that socioeconomic determinants such as race, income, college education, and insurance rate play in tertiary laryngology clinic utilization for the evaluation of dysphonia.
Objectives: To determine the impact of patient demographics and socioeconomic factors on the utilization of tertiary laryngology care services for evaluation of dysphonia in a metropolitan area.
Study Design: The entire electronic health record of our academic center was interrogated for patient demographics, diagnosis, and clinical provider for a 10 year window between 2009 and 2019.
Methods: The association between selected determinants of health and tertiary laryngology utilization were assessed by multivariate regression analyses. Laryngology utilization rates were calculated for each regional ZIP code and correlated with census data for median income and education. Patient characteristics (age, gender, race, insurance status) and population level data (median income and education level) from the surrounding counties, health system, and otolaryngology department were compared to utilization of tertiary laryngology services for dysphonia.
Results: 7,066 patients with a diagnosis of dysphonia used tertiary laryngology services at our institution between 2009-2019 (out of a total of 1,365,021 health system patients). Patients were older (62), more likely to be female (63.7%), and insured (97.9%) when compared to the surrounding population. Adjusted analyses showed insurance, education level, and Black race to be independently associated with tertiary care utilization. Median income alone was not an independent contributing factor in our region.
Conclusions: Utilization of tertiary laryngology services correlated with insurance, education level, and race, but income was not an independent factor in our region. These results both expand upon previous findings as well as provide new information regarding determinants of access to tertiary laryngology care.