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Nationwide Circumcision Trends: 2003 to 2016

2020; Lippincott Williams & Wilkins; Volume: 205; Issue: 1 Linguagem: Inglês

10.1097/ju.0000000000001316

1527-3792

Deborah L. Jacobson, Lauren C. Balmert, Jane L. Holl, Ilina Rosoklija, Matthew M. Davis, Emilie K. Johnson,

Ethics and Legal Issues in Pediatric Healthcare

No AccessJournal of UrologyPediatric Urology1 Jan 2021Nationwide Circumcision Trends: 2003 to 2016 Deborah L. Jacobson, Lauren C. Balmert, Jane L. Holl, Ilina Rosoklija, Matthew M. Davis, and Emilie K. Johnson Deborah L. JacobsonDeborah L. Jacobson Division of Pediatric Urology, University of Utah, Primary Children's Hospital, Salt Lake City, Utah , Lauren C. BalmertLauren C. Balmert Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, Illinois , Jane L. HollJane L. Holl Division of Biological Sciences, University of Chicago, Chicago, Illinois , Ilina RosoklijaIlina Rosoklija Division of Pediatric Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois , Matthew M. DavisMatthew M. Davis Department of Pediatrics, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois , and Emilie K. JohnsonEmilie K. Johnson †Correspondence: Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 24, Chicago, Illinois 60611-2605 telephone: 312-227-6340; FAX: 312-227-9412; E-mail Address: [email protected] Division of Pediatric Urology, Department of Urology, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois View All Author Informationhttps://doi.org/10.1097/JU.0000000000001316AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Among some populations access to neonatal circumcision has become increasingly limited despite evidence of its benefits. This study examines national neonatal circumcision trends before and after the 2012 American Academy of Pediatrics recommendation for neonatal circumcision reimbursement. Materials and Methods: A retrospective cohort study of boys aged 28 days or less was conducted using data from the Kids' Inpatient Database (2003 to 2016). Boys who underwent neonatal circumcision prior to discharge were compared to boys who did not. Boys with coagulopathies, penile anomalies or a history of prematurity were excluded. Results: An estimated 8,038,289 boys comprised the final cohort. Boys were primarily White (53.7%), privately insured (49.1%) and cared for at large (60.8%) teaching (49.4%) hospitals in metropolitan areas (84.1%). While 55.0% underwent circumcision prior to discharge, neonatal circumcision rates decreased significantly over time (p <0.0001). Black (68.0%) or White (66.0%) boys, boys in the highest income quartile (60.7%) and Midwestern boys (75.0%) were most likely to be circumcised. Neonatal circumcision was significantly more common among privately (64.9%) than publicly (44.6%) insured boys after controlling for demographics, region, hospital characteristics and year (p <0.0001). The odds of circumcision over time were not significantly different in the years before vs after 2012 (p=0.28). Conclusions: Among approximately 8 million boys sampled over a 13-year period 55.0% underwent neonatal circumcision. The rate of neonatal circumcision varied widely by region, race and socioeconomic status. The finding that boys with public insurance have lower circumcision rates in all years may be related to lack of circumcision access for boys with public insurance. References 1. American Academy of Pediatrics Task Force on Circumcision: Circumcision policy statement. Pediatrics 1999; 103: 686. Google Scholar 2. : Report of the ad hoc task force on circumcision. Pediatrics 1975; 56: 610. Google Scholar 3. : Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 2007; 369: 657. Google Scholar 4. : Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 2007; 369: 643. 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Volume 205Issue 1January 2021Page: 257-263Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordscircumcisioninsurance coveragemalepediatricschildadvisory committeesAcknowledgmentDr. Timothy B. Lautz helped with project development and manuscript editing.MetricsAuthor Information Deborah L. Jacobson Division of Pediatric Urology, University of Utah, Primary Children's Hospital, Salt Lake City, Utah More articles by this author Lauren C. Balmert Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, Illinois More articles by this author Jane L. Holl Division of Biological Sciences, University of Chicago, Chicago, Illinois More articles by this author Ilina Rosoklija Division of Pediatric Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois More articles by this author Matthew M. Davis Department of Pediatrics, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois More articles by this author Emilie K. Johnson Division of Pediatric Urology, Department of Urology, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois †Correspondence: Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 24, Chicago, Illinois 60611-2605 telephone: 312-227-6340; FAX: 312-227-9412; E-mail Address: [email protected] Funded by the Urology Care Foundation (2019−2021), Societies for Pediatric Urology and Sushil Lacy MD Research Scholar Award. More articles by this author Expand All Advertisement PDF DownloadLoading ...