According to a report published online by JAMA Otolaryngology-Head & Neck Surgery, those children who only have public insurance waited longer after initial evaluation for sleep-disordered breathing (SDB) to undergo polysomnography (PSG, the gold standard diagnostic test) and also waited longer after PSG to have surgery to treat the condition with adenotonsillectomy (AT) compared with those children who were privately insured.
Low socioeconomic status (SES) is definitely a barrier to quality care and improved health outcomes not just to children alone but also to everyone else. SDB is a spectrum of sleep disruption that ranges from snoring to obstructive sleep apnea (OSA). According to the background of the study, low SES is a risk factor for SDB. PSG is an overnight sleep test and is the standard for diagnosing OSA.
The researchers, Emily F. Boss, M.D., M.P.H., of the Johns Hopkins School of Medicine, Baltimore, and her co-authors examined the timing of PSG in relation to ultimate surgical therapy with AT and the differences based on the SES as measured by receipt of public insurance. The study observed the patients that were newly evaluated for SDB over a period of three months in the outpatient pediatric otolaryngology clinics who did not have a prior PSG ordered and had a minimum of one year of follow-up.
According to the results of the study, the children with public insurance who obtained PSG waited longer between the initial encounter and PSG (average interval, 141.1 days) than children who were privately insured (average interval, 49.9 days).