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Int J Pediatr Otorhinolaryngol. 2018 Mar;106:85-90. doi: 10.1016/j.ijporl.2018.01.010. Epub 2018 Feb 2.

Geographic health disparities in the Los Angeles pediatric esophageal foreign body population.

Author information

1
Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: kevin.hur@med.usc.edu.
2
Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
3
Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Otolaryngology - Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Abstract

OBJECTIVE:

To assess geographical sociodemographic differences in the pediatric esophageal foreign body population of Los Angeles.

METHODS:

We retrospectively reviewed the medical records of 128 consecutive pediatric patients at Children's Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a retained foreign body in the esophagus removed by rigid or flexible esophagoscopy. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fisher's exact test, and multivariable logistic regression.

RESULTS:

The average age of patients with a retained esophageal foreign body in this study was 2.5 years old, 52.3% were male, 91.4% had no past medical history, 53.1% were Hispanic, 82.0% had public health insurance, and 63.3% were transfers from an outside hospital. The most common foreign body removed was a coin. There were no significant differences in gender, race, type of health insurance, or income between patients that lived within 10 miles of CHLA versus farther than 10 miles. On multivariable analysis, zip codes with a high volume of esophageal foreign bodies were more likely to be lower income neighborhoods. Gender, race, type of health insurance, and distance from CHLA were not risk factors for zip codes with a high volume of esophageal foreign bodies.

CONCLUSION:

Geographic areas in the greater Los Angeles community with a high volume of retained esophageal foreign bodies requiring endoscopic removal at our institution are associated with lower income neighborhoods. Further studies should be performed to better understand health disparities within the U.S. pediatric esophageal foreign body population.

KEYWORDS:

Aerodigestive foreign body; Esophageal foreign body; Geospatial health; Health disparities; Los Angeles

PMID:
29447899
DOI:
10.1016/j.ijporl.2018.01.010
[Indexed for MEDLINE]

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