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Tonsillectomy compared to acute tonsillitis in children: a comparison study of societal costs
No full textTonsillectomy compared to acute tonsillitis in children: a comparison study of societal cost. Introduction and aim: Tonsillectomy is one of the most commonly performed surgical procedures in children; its main indications are recurrent episodes of acute tonsillitis and adenotonsillar hypertrophy. The effectiveness of tonsillectomy for severe recurrent tonsillitis is generally accepted; however its socio-economic cost is less well investigated. This study aims to determine and compare the societal cost of a tonsillectomy and a severe throat infection. Materials and methods: The costs for both tonsillectomy and severe throat infection were evaluated. Costs of the surgical procedure and hospital stay were calculated based on resource use and personnel input at the participating hospital. The cost of work-related disability for both treatments was measured based on a questionnaire filled in by 275 parents of children undergoing a tonsillectomy. Data from two Belgian institutions (NIS and FOD) were used to calculate the cost of parents' absenteeism. Results: An episode of acute tonsillitis in the child results in a longer period of parents' work absenteeism (mean of 3.1 +/- 0.3 days) compared to tonsillectomy (2.2 +/- 0.2 days). The cost of economic productivity loss amounts to (sic) 613 (NIS) or (sic) 759 (FOD) for acute tonsillitis and (sic) 435 (NIS) or (sic) 539 (POD) for a tonsillectomy. The medical costs linked to the surgical procedure at the local department correspond to (sic) 535 and for an acute tonsillitis to (sic) 46. Conclusions: From societal perspective, a tonsillectomy costs the equivalent of 1.4 times the cost of a severe throat infection. This indicates that in children suffering from recurrent acute tonsillitis, watchful waiting results in a higher cost compared to tonsillectomy, given the cumulative costs of parents' absenteeism
COST-EFFECTIVENESS OF CHILDHOOD TONSILLECTOMY COMPARED TO WATCHFUL WAITING: IMPACT OF ECONOMIC PRODUCTIVITY LOSS CAUSED BY PARENTS’ WORK ABSENTEEISM
No full textIntroduction and aim: Tonsillectomy is one of the most commonly performed surgical procedures in children. The main reason for performing this surgery is recurrent episodes of acute tonsillitis. Economic loss of productivity caused by parents’ work absenteeism is an underestimated factor in the total cost linked to children’s illness. The aim of this study was to investigate the cost-effectiveness of tonsillectomy compared to watchful waiting in children with recurrent episodes of acute tonsillitis and the role of economic productivity loss in this calculation.
Materials and Methods: 275 parents of children undergoing tonsillectomy in Ziekenhuis Oost Limburg provided information about their work absenteeism caused by their children’s surgery. Information about the work absence for an episode of acute tonsillitis was provided retrospectively. Information was assessed by a self-administered questionnaire. Socio-economic costs caused by the parents’ productivity loss were assessed based on the total labor cost calculated by the NIS in 2000 and converted to the year 2008. Costs of surgical procedure and hospital stay were calculated on resource use and personnel input in the participating Hospital. Hospitalization risk after tonsillectomy was considered to be comparable to hospitalization rate for acute tonsillitis.
Results: An episode of acute tonsillitis in the child results in a longer period of parents’ work absenteeism (mean:3.79 days, 95% CI:3.27-4.31) compared to tonsillectomy (mean:2.97 days, 95%, CI:2.61-3.31) leading to a higher cost of economic productivity loss caused by tonsillitis (746.06€) compared to tonsillectomy (584.65€). The general costs linked to surgical procedure correspond to 605.45€ per child. The general costs linked to an acute tonsillitis are estimated at 186.46€.
Conclusions: In children suffering from recurrent episodes of acute tonsillitis, watchful waiting results in a higher economic loss of productivity compared to tonsillectomy. At the level of cost-effectiveness, 1.2 episodes of acute tonsillitis per year justify a tonsillectomy.
(totale kost TE = 1190.102€, totale kost angina = 967.959€
COST-EFFECTIVENESS OF CHILDHOOD TONSILLECTOMY COMPARED TO WATCHFUL WAITING: IMPACT OF ECONOMIC PRODUCTIVITY LOSS CAUSED BY PARENTS’ WORK ABSENTEEISM
No full textIntroduction and aim: Tonsillectomy is one of the most commonly performed surgical procedures in children. The main reason for performing this surgery is recurrent episodes of acute tonsillitis. Economic loss of productivity caused by parents’ work absenteeism is an underestimated factor in the total cost linked to children’s illness. The aim of this study was to investigate the cost-effectiveness of tonsillectomy compared to watchful waiting in children with recurrent episodes of acute tonsillitis and the role of economic productivity loss in this calculation.
Materials and Methods: 275 parents of children undergoing tonsillectomy in Ziekenhuis Oost Limburg provided information about their work absenteeism caused by their children’s surgery. Information about the work absence for an episode of acute tonsillitis was provided retrospectively. Information was assessed by a self-administered questionnaire. Socio-economic costs caused by the parents’ productivity loss were assessed based on the total labor cost calculated by the NIS in 2000 and converted to the year 2008. Costs of surgical procedure and hospital stay were calculated on resource use and personnel input in the participating Hospital. Hospitalization risk after tonsillectomy was considered to be comparable to hospitalization rate for acute tonsillitis.
Results: An episode of acute tonsillitis in the child results in a longer period of parents’ work absenteeism (mean:3.79 days, 95% CI:3.27-4.31) compared to tonsillectomy (mean:2.97 days, 95%, CI:2.61-3.31) leading to a higher cost of economic productivity loss caused by tonsillitis (746.06€) compared to tonsillectomy (584.65€). The general costs linked to surgical procedure correspond to 605.45€ per child. The general costs linked to an acute tonsillitis are estimated at 186.46€.
Conclusions: In children suffering from recurrent episodes of acute tonsillitis, watchful waiting results in a higher economic loss of productivity compared to tonsillectomy. At the level of cost-effectiveness, 1.2 episodes of acute tonsillitis per year justify a tonsillectomy.
(totale kost TE = 1190.102€, totale kost angina = 967.959€
Effect of adenotonsillectomy on the use of respiratory medication
No full textOBJECTIVE: Recurrent tonsillitis and upper respiratory tract obstruction due to adenotonsillar hypertrophy are the most common indications for (adeno)tonsillectomy ((A)TE). Symptoms of upper respiratory tract infection and obstruction can, however, be attributed to lower airway pathology and thus treated with respiratory medication - this is non-antimicrobial medication used for lower respiratory diseases like bronchitis, bronchiolitis, asthma and episodic wheezing. The aim of this study is to investigate the effect of the current (A)TE practice in Belgium on the use of respiratory medication in subjects aged 0-15. METHODS: Retrospective data on 11.114 subjects aged 0-15years old who underwent (A)TE from January 1st 2002 until Sept 30th 2003 were retrieved from the database of the Christelijke Mutualiteit, the largest mutual health insurance society in Belgium. We compared the use of respiratory medication 12months before and 12months after (A)TE. RESULTS: Out of 11.114 subjects, 4.654 received at least one prescription for respiratory medication in the year before and/or after (A)TE. In this subgroup, the median respiratory medication use reduced with 32% in the year after surgery. CONCLUSION: Compared with the year before surgery, the median use of respiratory medication in subjects aged 0-15 drastically reduces in the year after (A)TE. A possible reason for this reduction is that children with upper airway obstruction and infections are often wrongly diagnosed as having lower airway problems
Tonsillectomy compared to acute tonsillitis in children: a comparison study of societal costs
No full textTonsillectomy compared to acute tonsillitis in children: a comparison study of societal cost. Introduction and aim: Tonsillectomy is one of the most commonly performed surgical procedures in children; its main indications are recurrent episodes of acute tonsillitis and adenotonsillar hypertrophy. The effectiveness of tonsillectomy for severe recurrent tonsillitis is generally accepted; however its socio-economic cost is less well investigated. This study aims to determine and compare the societal cost of a tonsillectomy and a severe throat infection. Materials and methods: The costs for both tonsillectomy and severe throat infection were evaluated. Costs of the surgical procedure and hospital stay were calculated based on resource use and personnel input at the participating hospital. The cost of work-related disability for both treatments was measured based on a questionnaire filled in by 275 parents of children undergoing a tonsillectomy. Data from two Belgian institutions (NIS and FOD) were used to calculate the cost of parents' absenteeism. Results: An episode of acute tonsillitis in the child results in a longer period of parents' work absenteeism (mean of 3.1 +/- 0.3 days) compared to tonsillectomy (2.2 +/- 0.2 days). The cost of economic productivity loss amounts to (sic) 613 (NIS) or (sic) 759 (FOD) for acute tonsillitis and (sic) 435 (NIS) or (sic) 539 (POD) for a tonsillectomy. The medical costs linked to the surgical procedure at the local department correspond to (sic) 535 and for an acute tonsillitis to (sic) 46. Conclusions: From societal perspective, a tonsillectomy costs the equivalent of 1.4 times the cost of a severe throat infection. This indicates that in children suffering from recurrent acute tonsillitis, watchful waiting results in a higher cost compared to tonsillectomy, given the cumulative costs of parents' absenteeism
Antibiotic use and doctor visits are reduced after adenotonsillectomy
No full textOBJECTIVE A tonsillectomy, with or without an adenotomy ((A)TE), is a common surgical procedure in children. The most important indications are recurrent tonsillitis and upper airway obstruction secondary to adenotonsillar hypertrophy. The aim of this study was to investigate whether the current (A)TE practice in Belgium reduced the need for medical care. STUDY DESIGN AND METHODS The database of the Christelijke Mutualiteit, one of the most important health insurance organizations in Belgium, provided data on approximately 11,000 (A)TE's in children aged 0 to 15 years, performed by different ENT-specialists from Jan 1st 2002 to Sept 30th 2003. We compared the use of antibiotics during the 12 months before and the 12 months after (A)TE. We also compared the number of visits to pediatricians and general practitioners during the 12 months before and the 12 months after surgery. RESULTS The median antibiotic use dropped from 4 boxes in the year before the operation to 1 box in the year after the operation. The median number of doctor visits also dropped from 7 visits in the year before to 4 visits in the year after (A)TE. CONCLUSION Although there are no generally accepted guidelines on the indications for (A)TE in Belgium, the current practice effectively reduced the need for medical care
(Adeno)tonsillectomy: what is the impact on the immune system?
No full textObjectives: The effect of (adeno) tonsillectomy (ATE) on the immune system is still a point of discussion. In this study, we investigate the local and systemic immunological consequences of removing (adeno) tonsillar tissue, based on changes in immunoglobulin (Ig) levels, T and B lymphocyte counts, and frequency of pre- and post-operative upper airway infections. Methodology: We performed a literature review and included six studies examining short-term effects (= 1 year post-operative) of ATE on humoral and cellular immunity. The use of medication, frequency of visits to the doctor, cost-effectiveness of the procedure, and quality of life pre- and post-operatively were also used as outcome parameters for long-term effects. Results: In the short term, only one study showed a significant post-operative decrease in IgA, IgM, and IgG levels, as well as cytotoxic T-lymphocyte count. Two studies noted both a significant decrease in IgG levels and a significant increase in T helper cells. No significant change in Ig levels or lymphocyte counts were observed after ATE in the long term. Conclusion: There is no evidence that ATE compromises the immune system in either the short or long term. Physicians and researchers agree that ATE is an effective treatment for recurrent adenotonsillitis that improves quality of life and reduces the frequency of upper airway infections. However, additional long-term and large-scale studies are needed
(Adeno)tonsillectomy: what is the impact on the immune system?
No full textObjectives: The effect of (adeno) tonsillectomy (ATE) on the immune system is still a point of discussion. In this study, we investigate the local and systemic immunological consequences of removing (adeno) tonsillar tissue, based on changes in immunoglobulin (Ig) levels, T and B lymphocyte counts, and frequency of pre- and post-operative upper airway infections. Methodology: We performed a literature review and included six studies examining short-term effects (= 1 year post-operative) of ATE on humoral and cellular immunity. The use of medication, frequency of visits to the doctor, cost-effectiveness of the procedure, and quality of life pre- and post-operatively were also used as outcome parameters for long-term effects. Results: In the short term, only one study showed a significant post-operative decrease in IgA, IgM, and IgG levels, as well as cytotoxic T-lymphocyte count. Two studies noted both a significant decrease in IgG levels and a significant increase in T helper cells. No significant change in Ig levels or lymphocyte counts were observed after ATE in the long term. Conclusion: There is no evidence that ATE compromises the immune system in either the short or long term. Physicians and researchers agree that ATE is an effective treatment for recurrent adenotonsillitis that improves quality of life and reduces the frequency of upper airway infections. However, additional long-term and large-scale studies are needed
Antibiotic use and doctor visits are reduced after adenotonsillectomy
No full textOBJECTIVE A tonsillectomy, with or without an adenotomy ((A)TE), is a common surgical procedure in children. The most important indications are recurrent tonsillitis and upper airway obstruction secondary to adenotonsillar hypertrophy. The aim of this study was to investigate whether the current (A)TE practice in Belgium reduced the need for medical care. STUDY DESIGN AND METHODS The database of the Christelijke Mutualiteit, one of the most important health insurance organizations in Belgium, provided data on approximately 11,000 (A)TE's in children aged 0 to 15 years, performed by different ENT-specialists from Jan 1st 2002 to Sept 30th 2003. We compared the use of antibiotics during the 12 months before and the 12 months after (A)TE. We also compared the number of visits to pediatricians and general practitioners during the 12 months before and the 12 months after surgery. RESULTS The median antibiotic use dropped from 4 boxes in the year before the operation to 1 box in the year after the operation. The median number of doctor visits also dropped from 7 visits in the year before to 4 visits in the year after (A)TE. CONCLUSION Although there are no generally accepted guidelines on the indications for (A)TE in Belgium, the current practice effectively reduced the need for medical care
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