{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:41:26Z","timestamp":1765294886918,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T00:00:00Z","timestamp":1495497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1K08 HS22932\u201001"],"award-info":[{"award-number":["1K08 HS22932\u201001"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare number of infections and health care utilization in children insured by TRICARE with recurrent acute otitis media (RAOM) managed surgically with tympanostomy tube (TT) placement compared with those managed medically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective matched cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>TRICARE claims database from 2006 to 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>We matched TRICARE beneficiaries \u22645 years of age diagnosed with RAOM who underwent TT placement with those managed medically using 1:1 coarsened\u2010exact matching on age, sex, race, sponsor rank, and region. We used multivariable negative binomial regression to compare number of infections and health care utilization at 1 and 2 years. Outcomes were adjusted for rate of infection before treatment for RAOM, season of either TT placement or establishment of candidacy for TT placement, and comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 6659 pairs identified at 1\u2010year follow\u2010up, the TT group had fewer infections (1.96 vs 2.18, <jats:italic>P<\/jats:italic> &lt;. 001) and oral antibiotic prescriptions (1.52 vs 1.67, <jats:italic>P<\/jats:italic> &lt;. 001) but more visits to primary care physicians (4.36 vs 4.06, <jats:italic>P<\/jats:italic> &lt;. 0001) and otolaryngologists (1.21 vs 0.44, <jats:italic>P<\/jats:italic> &lt;. 0001) compared with the medically managed group. At 2\u2010year follow\u2010up, the benefits of TT placement were no longer seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TT placement for RAOM is associated with fewer infections and oral antibiotic prescriptions in the first year after surgery but more doctor visits. Benefits of TT placement do not appear to extend through the second year. Future research should investigate costs associated with TT placement vs medical management, as well as real\u2010time health care utilization with impact on patient symptoms and quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817707718","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T18:30:26Z","timestamp":1495564226000},"page":"867-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tympanostomy Tube Placement vs Medical Management for Recurrent Acute Otitis Media in TRICARE\u2010Insured Children"],"prefix":"10.1002","volume":"157","author":[{"given":"Nikhila","family":"Raol","sequence":"first","affiliation":[{"name":"Center for Surgery and Public Health Harvard Medical School and Harvard T. H. Chan School of Public Health Department of Surgery Brigham &amp; Women\u2019s Hospital Boston Massachusetts USA"},{"name":"Department of Otolaryngology Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meesha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Harvard Medical School and Harvard T. H. Chan School of Public Health Department of Surgery Brigham &amp; Women\u2019s Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily F.","family":"Boss","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA"},{"name":"Armstrong Institute for Patient Safety and Quality Johns Hopkins Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Harvard Medical School and Harvard T. H. Chan School of Public Health Department of Surgery Brigham &amp; Women\u2019s Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Scott","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Harvard Medical School and Harvard T. H. Chan School of Public Health Department of Surgery Brigham &amp; Women\u2019s Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Learn","sequence":"additional","affiliation":[{"name":"Department of Surgery Walter Reed National Military Medical Center Uniformed Services University of the Health Sciences Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel S.","family":"Weissman","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Harvard Medical School and Harvard T. H. 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