Access to care for children with symptoms of sleep disordered breathing

Objectives: To determine if children with sleep disordered breathing who have Medicaid insurance encounter more difficulty accessing an otolaryngologist than those with private insurance. Design: Retrospective study. Setting: Urban tertiary care pediatric hospital. Patients: Children referred for evaluation of sleep disordered breathing (SDB). Intervention: Survey of patients' parents and guardians. Main outcome measure: Timely access to an otolaryngologist in their community. Results: Ninety-seven patients were included. Fifty patients had private insurance, 47 had Medicaid. The mean age was 5 years for those with private insurance and 5.6 years for those with Medicaid (p=0.27). The symptoms of SDB in both groups were similar. It took an average of 1.97 weeks for the children in the private insurance group to get an appointment versus 10.8 weeks for those with Medicaid (p=0.002). The mean distance traveled by the children in the private insurance group was 9.86 miles compared to 18.05 miles for those with Medicaid (p=0.001). Conclusion: Children who were referred for evaluation of SDB were of similar age and had similar symptoms regardless of insurance type. Children with Medicaid wait longer and travel farther to see an otolaryngologist than children with private insurance.