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Barriers to pediatric cochlear implantation: A parental survey.

Abstract This study aims to (1) determine barriers in the pediatric cochlear implantation process specific to publicly insured patients, wherein delayed implantation has been reported, and (2) compare the perceived barriers between publicly and privately insured patients.
PMID
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Authors

Mayor MeshTerms
Keywords

Cochlear implantation

Healthcare access

Hearing loss

Pediatric otolaryngology

Quality improvement

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 29287873
OWN - NLM
STAT- MEDLINE
DCOM- 20180116
LR  - 20180116
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 104
DP  - 2018 Jan
TI  - Barriers to pediatric cochlear implantation: A parental survey.
PG  - 224-227
LID - S0165-5876(17)30569-4 [pii]
LID - 10.1016/j.ijporl.2017.11.026 [doi]
AB  - OBJECTIVE: This study aims to (1) determine barriers in the pediatric cochlear
      implantation process specific to publicly insured patients, wherein delayed
      implantation has been reported, and (2) compare the perceived barriers between
      publicly and privately insured patients. SETTING: Tertiary care cochlear
      implantation center at academic pediatric hospital. STUDY DESIGN: Cross-sectional
      survey, retrospective chart review. METHODS: The validated, 39 item Barriers to
      Care Questionnaire was administered to the parents of 80 recipients of cochlear
      implantation by two surgeons between 2013 and 2016. Survey results and diagnosis 
      to implant interval were compared based on public or private insurance status.
      Two-tailed Mann-Whitney and Fisher's exact test was used for statistical
      analysis. RESULTS: Of 110 cochlear implants, 27 of 80 (34%) English-speaking
      parents completed the survey. 15 were privately insured and 12 were publicly
      insured. 23 of 27 respondents received cochlear implantation for pre-lingual
      sensorineural hearing loss. Publicly insured patients had significantly longer
      median time from diagnosis to implant than privately insured (19 vs. 8 mo, p =
      0.01). The three worst scoring barrier categories for privately insured families 
      in order were Pragmatics, Expectations, and Marginalization, whereas for publicly
      insured families it was Pragmatics, Skills, and Expectations. The worst scoring
      question for privately insured patients was "Having to take time off work". For
      the publicly insured, it was "Lack of communication." CONCLUSION: Privately
      insured patients reported more barriers on the Barriers to Care Questionnaire
      than publicly insured patients did. Although pragmatics was the worst-scoring
      barrier category for both groups, difficulties found on the survey ranked
      differently for each group. This information can help providers address
      disparities and access barriers for vulnerable patients.
CI  - Published by Elsevier B.V.
FAU - Yang, Charles Q
AU  - Yang CQ
AD  - Department of Otolaryngology, Walter Reed National Military Medical Center, 8901 
      Wisconsin Avenue, Bethesda, MD 20889, USA. Electronic address:
      [email protected]
FAU - Reilly, Brian K
AU  - Reilly BK
AD  - Department of Otolaryngology, Children's National Medical Center, Washington,
      D.C., 111 Michigan Ave NW, Washington, DC 20010, USA.
FAU - Preciado, Diego A
AU  - Preciado DA
AD  - Department of Otolaryngology, Children's National Medical Center, Washington,
      D.C., 111 Michigan Ave NW, Washington, DC 20010, USA.
LA  - eng
PT  - Journal Article
DEP - 20171128
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Child
MH  - Cochlear Implantation/*statistics & numerical data
MH  - Cochlear Implants/*statistics & numerical data
MH  - Cross-Sectional Studies
MH  - Female
MH  - Hearing Loss, Sensorineural/*surgery
MH  - Humans
MH  - Insurance Coverage/*statistics & numerical data
MH  - Language
MH  - Male
MH  - Parents
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Cochlear implantation
OT  - Healthcare access
OT  - Hearing loss
OT  - Pediatric otolaryngology
OT  - Quality improvement
EDAT- 2017/12/31 06:00
MHDA- 2018/01/18 06:00
CRDT- 2017/12/31 06:00
PHST- 2017/09/17 00:00 [received]
PHST- 2017/11/21 00:00 [revised]
PHST- 2017/11/25 00:00 [accepted]
PHST- 2017/12/31 06:00 [entrez]
PHST- 2017/12/31 06:00 [pubmed]
PHST- 2018/01/18 06:00 [medline]
AID - S0165-5876(17)30569-4 [pii]
AID - 10.1016/j.ijporl.2017.11.026 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2018 Jan;104:224-227. doi:
      10.1016/j.ijporl.2017.11.026. Epub 2017 Nov 28.