Resource analysis of tonsillectomy in children

Shah, Udayan K.; Theroux, Zachary A.; Shah, Gopi; Parkes, W.; Schuck, Christine

doi:10.1002/lary.24388

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…In one study, the cost of using radiofrequency was 8 times higher than for monopolar cautery in pediatric adenotonsillectomy [26]. Also, coblation tonsillectomy has been shown to be considerably more expensive than electrocautery due to high costs for disposables, despite a shorter time in the operating theatre [27] .This important aspect needs further analysis, especially since tonsillotomy is usually performed with more expensive surgical methods than tonsillectomy [28]. The KPP database is a national Swedish database (http://www.skl.se) that includes the costs of different surgeries from 47 different hospitals in Sweden.…”

Section: Discussionmentioning

confidence: 99%

Indirect costs related to caregivers’ absence from work after paediatric tonsil surgery

Gudnadottir

Tennvall

Stalfors

et al. 2017

Eur Arch Otorhinolaryngol

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Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers’ absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1–11 were included, n = 4534. The number of days the child needed analgesics after surgery was used as a proxy to estimate the number of work days lost for the caregiver. Data from the Social Insurance Agency (Försäkringskassan) regarding the days the parents received temporary parental benefits in the month following surgery were also analysed. The indirect costs due to the caregivers’ absenteeism after tonsillectomy vs tonsillotomy were calculated, using the human capital method. The patient-reported use of postoperative analgesic use was 77% (n = 3510). Data from the Social Insurance Agency were gathered for all 4534 children. The mean duration of analgesic treatment was 4.6 days (indirect cost of EUR 747). The mean number of days with parental benefits was 2.9 (EUR 667). The indirect cost of tonsillectomy was 61% higher than that of tonsillotomy (EUR 1010 vs EUR 629). The results show that the choice of surgical method affects the indirect costs, favouring the use of tonsillotomy over tonsillectomy for the treatment of children with SDB, due to less postoperative pain.

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Section: Discussionmentioning

confidence: 99%

Indirect costs related to caregivers’ absence from work after paediatric tonsil surgery

Gudnadottir

Tennvall

Stalfors

et al. 2017

Eur Arch Otorhinolaryngol

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“…This is one of the most common childhood surgical interventions, as more than 530,000 are performed annually for those under 15 years of age. [36][37][38] This surgical procedure has evolved from one primarily addressing infectious processes to one performed for sleep disordered breathing. [39][40][41] In a prior investigation focusing on tonsillectomy, Stevenson et al found postoperative bleeding to be the most common complication associated with litigation.…”

Section: Discussionmentioning

confidence: 99%

Protecting the most vulnerable: Litigation from pediatric otolaryngologic procedures and conditions

et al. 2014

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Unique considerations specific to pediatric patients are involved in malpractice litigation, and damages awarded were considerable. By including the specific factors listed in this analysis in a comprehensive informed consent process, and recognizing concerns specific to this patient population, practitioners in multiple specialties may potentially reduce liability. Clear communication with parents is a critical component of this process.

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“…Although several studies suggest a decreased need for postoperative analgesia with intracapsular coblation techniques, a recent Cochrane review concluded the evidence supporting decreased postoperative pain with radiofrequency ablation to be inadequate . Other reports examining radiofrequency ablation have cited an increase in postoperative hemorrhage and surgical costs . Moreover, inconsistent studies have been published when examining surgical time and insufficient evidence exists to determine whether radiofrequency ablation is superior, in regard to intraoperative efficiency and speed of recovery, when compared to other methods …”

Section: Introductionmentioning

confidence: 99%

“…6,7 Other reports examining radiofrequency ablation have cited an increase in postoperative hemorrhage and surgical costs. 8,9 Moreover, inconsistent studies have been published when examining surgical time and insufficient evidence exists to determine whether radiofrequency ablation is superior, in regard to intraoperative efficiency and speed of recovery, when compared to other methods. 6,10 Pulsed-electron avalanche knife (PEAK) Plasma-Blade technology was recently developed and is reported to cause less collateral tissue damage than both radiofrequency ablation and electrocautery by utilizing low thermal temperatures, pulsed radiofrequency, and plasma mediated electroconduction.…”

Section: Introductionmentioning

confidence: 99%