Submitted as Triological Thesis by Udayan K. Shah, MD.
Resource analysis of tonsillectomy in children
Article first published online: 7 OCT 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 5, pages 1223–1228, May 2014
How to Cite
Shah, U. K., Theroux, Z., Shah, G. B., Parkes, W. J. and Schuck, C. (2014), Resource analysis of tonsillectomy in children. The Laryngoscope, 124: 1223–1228. doi: 10.1002/lary.24388
This work was performed at Nemours/Alfred I. duPont Hospital for Children.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 18 APR 2014
- Article first published online: 7 OCT 2013
- Accepted manuscript online: 23 SEP 2013 03:50AM EST
- Manuscript Accepted: 12 AUG 2013
- Manuscript Revised: 30 JUL 2013
- Cost containment;
- medical economics;
- sleep apnea;
To analyze variables that affect time and cost parameters of pediatric adenotonsillectomy.
Longitudinal 7-month retrospective review of sequential tonsil and adenoid surgery at a university pediatric tertiary care hospital.
All children aged 2 to 12 years who underwent adenotonsillectomy from May 2008 to October 2008 had charts and billing records analyzed for variations in charges and times of adenotonsillectomy according to patient age, body mass index for age (BMIFA), American Society of Anesthesiologists (ASA) status, surgical indication, technology used, and teaching status of case. A total of 214 children had records reviewed.
Statistically significant variations were observed for all measured parameters except for indications for surgery. Children 3 years and younger had shorter procedures (P = .005) and total operating room times (P = .037). Charges for supplies were lower for ASA 1 patients than for ASA 2 patients (P = .010). Obese children with elevated BMIFA required longer procedures (P = .039) and more expensive surgery (P = .003). Procedure times were shorter for Coblation (ArthroCare, Austin, TX) compared with electrocautery (P = .27) and for microdebrider compared with electrocautery (P < .001). Charges for Coblation were substantially higher (P < .001). Teaching cases took longer (P < .001).
Charges and times for adenotonsillectomy surgery varied by patient age, BMIFA, ASA status, tonsillectomy technique, and teaching case status. Clinically salient differences were noted for ASA status, BMIFA, and surgical technique. This method of cost analysis provides useful information for resource management in tonsillectomy.
Level of Evidence
2c. Laryngoscope, 124:1223–1228, 2014