Understanding pediatric inpatient conductive hearing loss: An analysis of patient demographics.

OBJECTIVE: Hearing loss is a common sensory impairment in children that affects quality of life and development. Early intervention, such as hearing aids and communication therapies, can help children overcome these challenges and lessen the impact on their development. The objective of this study was to identify specific patient demographic factors correlated with the prevalence of pediatric conductive hearing loss. STUDY DESIGN: The study utilized the Kids' Inpatient Database (KID) by the Agency for Healthcare Research and Quality which collects inpatient information from hospitals for patients under 21 years old. We included all patients discharged in 2016 diagnosed with conductive hearing loss, and excluded neonatal patients discharged within 28 days of birth. METHODS: Statistical analyses were performed using R Studio and IBM SPSS Statistics. Weighted odds ratios were calculated for conductive hearing loss in relation to race and income, and a multivariate regression analysis examined associations between demographic variables and race categories in conductive hearing loss. RESULTS: The prevalence of conductive hearing loss (CHL) in pediatric patients in 2016 was 51.62 cases per 100,000 patients. Non-Hispanic White patients had the highest prevalence, while Black patients had the highest likelihood of CHL compared to the overall population. Lower income levels were associated with a decreased probability of CHL diagnosis. After adjusting for age, sex, hospital region, insurance, and income on multivariate analysis, White and Black patients were less likely to be diagnosed with CHL. Furthermore, patients in specific income quartiles also had lower CHL likelihood compared to the general population. CONCLUSION: While Black patients had a higher likelihood of being diagnosed with CHL than the general population, socioeconomic factors such as income greatly influenced the likelihood of CHL diagnosis. Other significant factors included income, region of the country, sex, and age. Further research is needed to better understand and address healthcare disparities related to pediatric hearing loss.

Assessing Loss to Follow-up After Newborn Hearing Screening in the Neonatal Intensive Care Unit: Sociodemographic Factors That Affect Completion of Initial Audiological Evaluation.

OBJECTIVES: Neonatal intensive care unit (NICU) patients are at high risk for congenital hearing loss. Previous studies have found sociodemographic factors associated with loss to follow-up for newborn hearing screening, but none have specifically studied the NICU population. Our objective is to determine if demographics and socioeconomic status is associated with loss to follow-up in a newborn population with extended NICU stay. DESIGN: A retrospective cohort study was conducted on 443 NICU infants with extended NICU stay utilizing data extracted from infant and maternal medical records at an urban safety-net hospital. RESULTS: Younger maternal age (adjusted odds ratio [OR] 0.95, confidence interval [CI] 0.91 to 0.99), higher gravidity (adjusted OR 1.39, CI 1.12 to 1.72), and former smoking status (adjusted OR 2.57, CI 1.07-6.18) were identified as independent predictors of loss to follow-up for NHS after conducting a multivariable logistic regression. Demographic and socioeconomic variables, such as sex, parity, birth weight, mode of birth, highest level of maternal education, maternal race/ethnicity, zip code metrics, and maternal language were not found to be associated with loss to follow-up. CONCLUSIONS: Maternal age, gravidity, and smoking status are risk factors for loss to follow-up for NHS in newborns with extended NICU stay, a group at high risk for hearing loss. Our findings demonstrate that socioeconomic and demographic factors for loss to follow-up in the extended-stay NICU population are distinct from the well-baby population. Further investigation of these patients will allow prioritization of limited resources to subgroups within the extended-stay NICU population at risk for loss to follow-up for newborn hearing screening.

Loss to Follow-Up After Newborn Hearing Screening: Analysis of Risk Factors at a Massachusetts Urban Safety-Net Hospital.

OBJECTIVES: This study examines the unique factors that influence loss to follow-up after newborn hearing screening for patients at a Massachusetts urban safety-net hospital. We seek to characterize our patient population, investigate correlations between patient factors and rates of follow-up, and understand gaps in care. DESIGN: A retrospective chart review was conducted of patients born at an urban safety-net hospital from January 2015 through May 2018 who did not pass the newborn hearing screening in one or both ears. A total of 197 infants were included in our study. Outcomes of interest included rates and latency of follow-up appointments, infant demographics (sex, race, birth weight, risk factors for hearing loss), and maternal factors (age, marital status, smoking status, number of children). RESULTS: From January 2015 through May 2018, 17% (n = 34) of infants were lost to follow-up. Of those who attended an initial audiology evaluation, the median time between screening and appointment was 29 days. Newborns were 3.5 times at risk of being lost to follow-up if their mothers smoked during pregnancy compared to those whose mothers did not smoke. Further, newborns with multiple siblings in the home were less likely to utilize any audiological services. High-risk infants, such as those with an extended stay in the neonatal intensive care unit, were found to have higher rates of loss to follow-up. CONCLUSIONS: Our results indicate that patients at urban safety-net hospitals require increased support to decrease rates of loss to follow-up. In particular, strategies to aid mothers who smoke, have multiple children, or have high-risk infants can address gaps in care for newborns after hearing screening.