Impact of Insurance Status on Medical versus Surgical Management of Retropharyngeal Abscesses

Monday, October 13, 2025

10:00 AM - 10:06 AM EDT

Location: 233-234

Disclosure(s):

JB Eyring, MS3:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Wesley P. Allen, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Freddy A. Espinoza, S.B.:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Previous studies have suggested that surgical drainage of pediatric retropharyngeal abscesses (RPA) is more common in patients from lower socioeconomic and marginalized communities, potentially due to delayed presentation. This study expands on prior literature by evaluating the impact of insurance status on the likelihood of RPA drainage and on the subsequent length of stay.

Methods: This retrospective cohort study examined patients aged 0–18 diagnosed with retropharyngeal abscess (RPA) admitted to two children’s hospitals from January 2022 to December 2024. Outcomes included surgical drainage and length of stay. Predictors included patient age, insurance status, consulting surgeon and years of experience, lab results, and clinical characteristics. Home addresses were used to geographically assess social determinants of health. Logistic regression and t-tests evaluated associations.

Results: The 161 patients meeting inclusion criteria had a mean age of 5.0 years (SD: 4.2). The overall drainage rate was 37.3%, with surgeon-specific rates ranging from 33.3% to 52.9%. Uninsured patients had 3.4 times higher odds of drainage (60.0%) compared to insured patients (32.3%) in a multivariate logistic regression model (p < 0.05), controlling for social determinants (e.g., household income) and clinical factors (e.g., C-reactive protein level). The mean length of stay (2.8 days, SD: 1.4) did not differ significantly between drainage and non-drainage groups (2.7 vs. 2.8 days, p=0.83) or between insured and uninsured patients (2.8 vs. 2.6 days, p=0.67).

Conclusions: Uninsured patients were significantly more likely to require surgical drainage compared to those with insurance. This disparity may create both economic and medical challenges for potentially vulnerable populations, many of whom are uninsured.

Presenting Author(s)

JB Eyring, MS3

Medical Student
University of Utah School of Medicine
North Salt Lake, Utah, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

WA

Wesley P. Allen, BS

Medical Student
University of Utah School of Medicine
Salt Lake City, UT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Brandon M. Hemeyer, BS

Medical Student
University of Utah School of Medicine
Salt Lake City, UT, United States

Disclosure information not submitted.
NB

Nate Behrens, Medical Student

University of Utah, United States

Disclosure information not submitted.
SY

Samantha Yost, Medical Student

University of Utah, United States

Disclosure information not submitted.
Freddy A. Espinoza, S.B.

Medical Student
University of Utah
Salt Lake City, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Reema K. Padia, MD

Associate Professor
Primary Children's Hospital University of Utah Health
Cottonwood Heights, UT, United States

Disclosure information not submitted.
QO

Quinn T. Orb, MD

Assistant Professor
Primary Children's Hospital
Salt Lake City, UT, United States

Disclosure information not submitted.

Senior Author(s)

JM

Jeremy D. Meier, MD

Professor
University of Utah Health - Primary Children's Hospital
Holladay, UT, United States

Disclosure information not submitted.