Parental Income and Long‐Term Survival in Pediatric Tracheostomy: A Population‐Based Study in Taiwan

ABSTRACT Objective This retrospective, population‐based study investigated the influence of parental income on long‐term outcomes in pediatric tracheostomy in Taiwan. Methods We identified all inpatients who were aged < 18 years and received tracheostomy between 2000 and 2014 from Taiwan's National Health Insurance Research Database (NHIRD) and followed them until 2019. Parental income was determined by the monthly income of the primary caregiver in the year of the child's tracheostomy and was classified into low, middle, and high income groups based on year‐specific income distributions. Results Among 2031 children who were identified (mean age, 8.8 years; 64% boys), 707, and 615, and 709 were assigned to low‐, middle‐, and high‐income groups, respectively. Children in the low‐income group had significantly higher rates of in‐hospital death (24.2% vs. 5.1%), 1‐year mortality (42.2% vs. 9.6%), 5‐year mortality (68.0% vs. 19.6%), and overall mortality (77.5% vs. 29.8%) compared with those in the high‐income group (all p < 0.001). Multivariable analysis results indicated that children in the low‐income group had significantly higher rates of in‐hospital death (hazard ratio [HR] = 6.38), 1‐year mortality (HR = 5.28), 5‐year mortality (HR = 4.99), and overall mortality (HR = 4.48) compared with those in the high‐income group. Length of hospital stay and readmission rate did not differ significantly between the income groups. Conclusion Lower parental income was associated with increased risks of in‐hospital, 1‐year, 5‐year, and overall mortality in Taiwanese children undergoing tracheostomy. Level of Evidence 3