Influences of demographic changes and medical insurance status on tonsillectomy and adenoidectomy rates in Korea

Choi, Hyo Geun; Hah, J. Hun; Jung, Young Ho; Kim, Dong Wook; Sung, Myung‐Whun

doi:10.1007/s00405-013-2759-7

Cited by 15 publications

(17 citation statements)

References 14 publications

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“…Tonsillectomy with/without adenoidectomy is one of the most commonly performed surgeries, especially in children [1–3]. The reported rate of tonsillectomy in children and adolescents is 7.9 per 1,000 in the US [4] and 2.6 per 1,000 in Korea [3].…”

Section: Introductionmentioning

confidence: 99%

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Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study

et al. 2016

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ObjectivesThe objective of this study was to compare post-operative visits for upper respiratory infections (URIs) between tonsillectomy and non-tonsillectomy participants (controls).MethodsUsing the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched (age, sex, income, region, and pre-operative URI visit) tonsillectomy participants (5,831) and control participants (23,324) were selected. Post-operative visits for URI were measured from 1 to 9 years post-op. The equivalence test was used. The margin of equivalence of the difference (Tonsillectomy—Control group group) was set to -0.5 to 0.5.ResultsThere was no difference between the tonsillectomy and control group in 1- to 9-year post-op visits (-0.5 < 95% CI of difference < 0.5). URI visits gradually decreased from 5.5/2 years (pre-op) to 2.1/year (at 1 year post-op) and 1.4/year (at 9 years post-op) in both tonsillectomy and control groups. In the subgroup analysis (children Vs adolescent and adults; rare Vs frequent pre-operative URI), there was no difference in the number of post-op visits for URI between the tonsillectomy and control groups (-0.5 < 95% CI of difference < 0.5).ConclusionTonsillectomy does not provide a decrease in the number of post-operative visits for URI, and URI decreased over time whether or not a tonsillectomy was performed.

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Section: Introductionmentioning

confidence: 99%

“…The reported rate of tonsillectomy in children and adolescents is 7.9 per 1,000 in the US [4] and 2.6 per 1,000 in Korea [3]. Tonsillectomy is generally performed for recurrent sore throat or obstructive sleep apnea (OSA) [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study

et al. 2016

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“…The rate of tonsillectomy in those under 18 years old is 3.4 to 4.8 per 1,000 people in the US [ 2 , 3 ]. Our previous study reported this rate to be 2.58 per 1,000 people under 16 years old in Korea [ 4 ]. Tonsillectomy is commonly indicated for chronic tonsillar hypertrophy, chronic tonsillitis, or obstructive sleep apnea [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Tonsillectomy increases the risk of retropharyngeal and parapharyngeal abscesses in adults, but not in children: A national cohort study

et al. 2018

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ObjectivesThe purpose of this study is to evaluate the risk of retropharyngeal and parapharyngeal abscesses (deep neck infection) after tonsillectomy in Koreans using national cohort data.MethodsUsing the national cohort study from the Korean Health Insurance Review and Assessment Service, participants who had undergone a tonsillectomy (5,299) and control participants (21,196) were selected and matched 1:4 (for age, sex, income, region of residence, and pre-operative upper respiratory infection visits). The Cox-proportional hazard model was used. A crude model and an adjusted model for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia were used in this analysis. For the subgroup analyses, the participants were divided into 2 groups: children (≤ 14 years old) and adolescents and adults (≥ 15 years old).ResultsThe adjusted hazard ratio of deep neck infection after tonsillectomy was 1.43 (95% confidence interval, CI = 1.18–1.72, P < 0.001). In subgroup analysis, this ratio was 1.12 (95% CI = 0.86–1.47, P = 0.390) in children and 1.87 (95% CI = 1.43–2.45, P < 0.001) in adolescents and adults. The crude hazard ratios were almost the same as the adjusted ratios.ConclusionThe risk of deep neck infection was higher in the tonsillectomy group. The subgroup analysis showed a similar finding in the adolescent and adult group but not in the child group.

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“…Following the introduction of a national clinical guideline for the management of sore throat and indications for tonsillectomy, Mcleod et al reported a probable association between an increase in admissions with tonsillitis or peritonsillar abscess and a decrease in the rate of tonsillectomy [ 13 ]. In contrast to the abundance of information on the incidence trends of AT in Western countries [ 3 – 5 , 14 , 15 ], limited data exist for Eastern countries [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with changing indications for adenotonsillectomy: A population-based longitudinal study

et al. 2018

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ObjectiveAdenotonsillectomy (AT) is one of the most common surgical procedures performed in children and adults. We aim to assess the factors associated with changes in the incidence of and indications for AT using population-level data.Study designThis retrospective cohort study investigated patients who underwent AT between 1997 and 2010 by using data from the Taiwan National Health Insurance Research Database. We examined surgical rates and indications by the calendar year as well as age, sex, hospital level, and insured residence areas for the correlating factors.ResultsThe average annual incidence rate of AT was 14.7 per 100,000 individuals during 1997–2010. Pediatric (<18 years) patients represented 48.2% of the total AT population. More than 99% of the patients underwent the AT procedures as an inpatient intervention. Longitudinal data demonstrated an increasing trend in the pediatric AT rates from 1997 (4.3/100,000) to 2010 (5.7/100,000) (p = 0.029). In the adult subgroup, a decreasing prevalence of infectious indications (p = 0.014) coincided with an increasing neoplastic indications (p = 0.001). In the pediatric subgroup, the prevalence of obstructive indications increased (p = 0.002). The logistic regression analyses indicated that the significant factors associated with the changing surgical indications for AT were the age in the adult subgroup and hospital level in the pediatric subgroup.ConclusionsThis study revealed a low AT rate in Taiwan than that in other countries. Pediatric AT incidence increased during 1997–2010. Although a rising prevalence of obstructive and neoplastic indications was noted, infection remained the most common indications for AT. Age in the adult subgroup and hospital level in the pediatric subgroup were factors associated with the changing indications for AT.

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Influences of demographic changes and medical insurance status on tonsillectomy and adenoidectomy rates in Korea

Cited by 15 publications

References 14 publications

Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study

Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study

Tonsillectomy increases the risk of retropharyngeal and parapharyngeal abscesses in adults, but not in children: A national cohort study

Factors associated with changing indications for adenotonsillectomy: A population-based longitudinal study

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