VENTILATION TUBE PLACEMENT IN A MANAGED CARE POPULATION

To date, little information is available regarding the actual incidenc e of ventilation tube: placement in a known population of pediatric pa tients. We evaluated the incidence of ventilation tube placement in a known population of pediatric patients whose health coverage is provid ed through a large managed care organization. Epidemiological data pro vided by a large managed care organization on a population of 67995 ch ildren from July 1, 1993, through June 30, 1994, were evaluated. A pri mary care physician referral to an otolaryngologist was required for a ssessment, and precertification for ventilation tube placement was obt ained using explicit criteria developed by a large national health ser vices utilization review organization. In children younger than 24 mon ths, 30.11% underwent ventilation tube placement compared with an over all incidence of 4.49% for all children younger than 18 years, The det ails of this study are presented to understand better the implications of the epidemiology of otitis media and how it relates to a physician 's participation in a managed care organization.