Healthcare costs of acute and chronic tonsillar conditions in the pediatric population in the United States

Duarte, Victor M.; McGrath, Caitlin; Shapiro, Nina L.; Bhattacharrya, Neil

doi:10.1016/j.ijporl.2015.04.019

Cited by 12 publications

(11 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A tonsillectomy is one of the most frequent surgical procedures performed on children, with a growing proportion now performed to treat sleep apnea disorders such as OSA [1]. There are significant direct medical costs as well as an indirect economic burden associated with tonsillar hyperplasia [2,3]. Healthcare expenditure for treatment of acute and chronic RT in pediatric patients from the United States was estimated to be in excess of US $1.355 billion in 2015 [3].…”

Section: Introductionmentioning

confidence: 99%

“…There are significant direct medical costs as well as an indirect economic burden associated with tonsillar hyperplasia [2,3]. Healthcare expenditure for treatment of acute and chronic RT in pediatric patients from the United States was estimated to be in excess of US $1.355 billion in 2015 [3]. Of particular concern is the high usage of antibiotics to treat these conditions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Superantigen-Producing Bacteria on T Cells from Tonsillar Hyperplasia

et al. 2019

View full text Add to dashboard Cite

Staphylococcus aureus and Group A Streptococcus (GAS) are common occupants of the tonsils and many strains produce potent exotoxins (mitogens) that directly target T cells, which could be a driver for tonsillar hyperplasia. Tonsil tissues from 41 patients were tested for these bacteria in conjunction with profiling of B and T cells by flow cytometry. S. aureus and GAS were detected in tonsil tissue from 44% and 7%, respectively, of patients by bacteriological culture; immuno-histology showed bacteria in close proximity to both B and T lymphocytes. The presence of tonsillar S. aureus did not alter B or T cell populations, whereas peripheral blood mucosal-associated invariant T (MAIT) cells were significantly increased in S. aureus culture positive individuals (p < 0.006). Alterations of tonsil CD4+ TCR Vβ family members relative to peripheral blood were evident in 29 patients. Three patients had strong TCR Vβ skewing indicative of recent exposure to superantigens, their tonsils contained mitogenic bacteria, and supernatants from these bacteria were used to partially recapitulate the skewing profile in vitro, supporting the notion that superantigens can target tonsillar T cells in situ. Tonsils are a reservoir for superantigen-producing bacteria with the capacity to alter the composition and function of key immune cells.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Superantigen-Producing Bacteria on T Cells from Tonsillar Hyperplasia

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The cost of treatment of tonsillitis was high for the average household, and much higher costs of €1048 and €1106.8 ± 331.3 (US1303 ± 390) have been reported by Leupe et al [16] and Duarte et al [17], respectively. The costs of drugs and laboratory investigations were the highest contributors to the medical cost of treatment of tonsillitis.…”

Section: Discussionmentioning

confidence: 82%

“…An extensive literature search revealed that studies that had evaluated the economic cost of treatment for acute tonsillitis were either conducted in developed countries with different cost structures compared to developing countries like Nigeria [16,17] or summed the cost of the surgical and medical treatment [18][19][20] or combined the populations of children and adults in one study [21]. Leupe et al [16] and Duarte et al [17] in their study of children in developed countries reported a higher cost of treatment for acute tonsilitis, a many hospital visits, and average of 2.1 prescription fills annually in children with acute tonsillitis more when compared to children without acute tonsillitis (p < 0.001). Chang et al [18] and Wilson et al [19] focused on the cost-effectiveness of surgical treatment of chronic adenotonsillar hypertrophy in children.…”

Section: Key Points For Decision Makersmentioning

confidence: 99%

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Ughasoro

Akpeh

Echendu

et al. 2021

PharmacoEconomics Open

View full text Add to dashboard Cite

Background Acute tonsillitis has become one of the main reasons why children visit healthcare facilities in Nigeria. Presently, there is no information on the costs of its treatment, and this study aimed at determining these costs. Methods The study was conducted in two hospitals located in southeast Nigeria. The information was obtained in two ways: (1) retrospectively from the medical records of children treated for acute tonsillitis over a period of 5 years and (2) cross-sectionally from children who presented with complaints of acute tonsillitis over a period of 7 months. The information obtained was the costs of self-medication and hospital treatment, and the payment mechanisms used to settle these costs. The human capital method approach was used to estimate the indirect cost (loss in productivity) from the caregivers' absenteeism from work. Results The mean costs of self-medication and hospital treatment for acute tonsillitis in children were €3.85 and €13.48, respectively. The indirect cost was €11.31. The mean total cost of treatment of acute tonsillitis was €23.80. The proportion of households that suffered catastrophic health expenditure (CHE) from the treatment of acute tonsillitis was 55 (55%). CHE was highest [22 (91.7%)] in the lowest socio-economic quartile compared to households in the highest quartile [4 (16.7%)], and the difference was statistically significant (p = 0.02). Of the 72 participants whose payment mechanisms were documented, the proportion who paid out of pocket was 53 (73.6%), and 19 (26.4%) used the National Health Insurance Scheme. Conclusion The costs of treatment for children with acute tonsillitis were high, and most of these costs were settled out-ofpocket. The costs for laboratory investigations, drugs, and productivity loss contributed to these high costs. There is a need to cover the costs of non-surgical treatment of acute tonsillitis in social health insurance and improve efforts to increase the coverage of the health insurance scheme.

show abstract

“…Duarte et al . calculated an average cost of $1098 per child per year for chronic tonsillitis. We led a cost analysis of TORS procedures in our department (unpublished data) and the comprehensive cost of each surgery with one day of hospital stay is stated around 3000 euros.…”

Section: Discussionmentioning

confidence: 99%