Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy

Abstract Geographic variation of paediatric tonsillectomy, with or without adenoidectomy, (A/T) has been described since the 1930s until today but no studies have investigated the factors associated with this variation. This study described the geographical distribution of paediatric A/T across the...

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Autores principales:	Aimy H. L. Tran, Danny Liew, Rosemary S. C. Horne, Joanne Rimmer, Gillian M. Nixon
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9030d956c1894cdbbe4e6eb1959890f6
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spelling	oai:doaj.org-article:9030d956c1894cdbbe4e6eb1959890f62021-12-02T18:49:29ZSociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy10.1038/s41598-021-95522-52045-2322https://doaj.org/article/9030d956c1894cdbbe4e6eb1959890f62021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95522-5https://doaj.org/toc/2045-2322Abstract Geographic variation of paediatric tonsillectomy, with or without adenoidectomy, (A/T) has been described since the 1930s until today but no studies have investigated the factors associated with this variation. This study described the geographical distribution of paediatric A/T across the state of Victoria, Australia, and investigated area-level factors associated with this variation. We used linked administrative datasets capturing all paediatric A/T performed between 2010 and 2015 in Victoria. Surgery data were collapsed by patient residence to the level of Local Government Area. Regression models were used to investigate the association between likelihood of surgery and area-level factors. We found a 10.2-fold difference in A/T rates across the state, with areas of higher rates more in regional than metropolitan areas. Area-level factors associated with geographic variation of A/T were percentage of children aged 5–9 years (IRR 1.07, 95%CI 1.01–1.14, P = 0.03) and low English language proficiency (IRR 0.95, 95% CI 0.90–0.99, P = 0.03). In a sub-population analysis of surgeries in the public sector, these factors were low maternal educational attainment (IRR 1.09, 95% CI 1.02–1.16, P < 0.001) and surgical waiting time (IRR 0.99635 95% CI 0.99273–0.99997, P = 0.048). Identifying areas of focus for improvement and factors associated with geographic variation will assist in improving equitable provision of paediatric A/T and decrease variability within regions.Aimy H. L. TranDanny LiewRosemary S. C. HorneJoanne RimmerGillian M. NixonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Aimy H. L. Tran Danny Liew Rosemary S. C. Horne Joanne Rimmer Gillian M. Nixon Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
description	Abstract Geographic variation of paediatric tonsillectomy, with or without adenoidectomy, (A/T) has been described since the 1930s until today but no studies have investigated the factors associated with this variation. This study described the geographical distribution of paediatric A/T across the state of Victoria, Australia, and investigated area-level factors associated with this variation. We used linked administrative datasets capturing all paediatric A/T performed between 2010 and 2015 in Victoria. Surgery data were collapsed by patient residence to the level of Local Government Area. Regression models were used to investigate the association between likelihood of surgery and area-level factors. We found a 10.2-fold difference in A/T rates across the state, with areas of higher rates more in regional than metropolitan areas. Area-level factors associated with geographic variation of A/T were percentage of children aged 5–9 years (IRR 1.07, 95%CI 1.01–1.14, P = 0.03) and low English language proficiency (IRR 0.95, 95% CI 0.90–0.99, P = 0.03). In a sub-population analysis of surgeries in the public sector, these factors were low maternal educational attainment (IRR 1.09, 95% CI 1.02–1.16, P < 0.001) and surgical waiting time (IRR 0.99635 95% CI 0.99273–0.99997, P = 0.048). Identifying areas of focus for improvement and factors associated with geographic variation will assist in improving equitable provision of paediatric A/T and decrease variability within regions.
format	article
author	Aimy H. L. Tran Danny Liew Rosemary S. C. Horne Joanne Rimmer Gillian M. Nixon
author_facet	Aimy H. L. Tran Danny Liew Rosemary S. C. Horne Joanne Rimmer Gillian M. Nixon
author_sort	Aimy H. L. Tran
title	Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
title_short	Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
title_full	Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
title_fullStr	Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
title_full_unstemmed	Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
title_sort	sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9030d956c1894cdbbe4e6eb1959890f6
work_keys_str_mv	AT aimyhltran sociodemographicassociationsofgeographicvariationinpaediatrictonsillectomyandadenoidectomy AT dannyliew sociodemographicassociationsofgeographicvariationinpaediatrictonsillectomyandadenoidectomy AT rosemaryschorne sociodemographicassociationsofgeographicvariationinpaediatrictonsillectomyandadenoidectomy AT joannerimmer sociodemographicassociationsofgeographicvariationinpaediatrictonsillectomyandadenoidectomy AT gillianmnixon sociodemographicassociationsofgeographicvariationinpaediatrictonsillectomyandadenoidectomy
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Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy

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