Finnish adenoidectomy and tympanostomy rates in children; national variation

Variability of adenoidectomy/tonsillectomy rates among children of the Veneto Region, Italy

“…This finding suggests that variability between Local Health Units is better explained by surgeons' general propensity to tonsillectomy and adenoidectomy procedures rather than by different underlying disease rates. All the above indicate that national guidelines did not have a major impact on the selection of children for surgery, similarly to that observed in other countries [ 13 ]. An update of national guidelines has been issued in 2008, further restricting indications to ventilation-tube placement and adenoidectomy in recurrent otitis [ 16 ], but strategies should be implemented for enhancing adherence among physicians, who could see guidelines both as a threat to their decisional autonomy [ 17 ] and as a cost-cutting tool for health care.…”

“…A/T rates show a wide variability between countries [ 8 , 9 ], but it has been long recognized that, despite differences in average rates across countries, even more striking variations always exist from area to area of the same country [ 10 - 13 ]. A wide small-area variation in intervention rates suggests that there is a high degree of "clinical uncertainty" about the indications [ 14 ].…”

Implementation of neonatal screening for hearing impairment: Influence on pediatric otitis media surgery in The Netherlands

“…This peak incidence in treatment at this age has also been found in Finland and Norway by Haapkyla et al [8,9]. We analyzed the number of children treated surgically for OM aged 0-23 months per month as Engel did, to investigate whether the disappearance of the hearing screen at 9 months of age around 2004 would affect the rate of treatment.…”

Effectiveness of the Ten-valent Pneumococcal Conjugate Vaccine Against Tympanostomy Tube Placements in a Cluster-randomized Trial

“…The variation has been documented in Finland and internationally also earlier 19,20 and was mainly because of the private office procedures (Fig. 3).…”