Cost analysis of tonsillectomy in children using medicaid data

Jen Jen Chang, Paula Buchanan, Caroline Geremakis, Kazim Sheikh, Ron B. Mitchell

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Objective To evaluate the cost-effectiveness of adenotonsillectomy (T&A) for adenotonsillar hypertrophy and recurrent tonsillitis through the use of Missouri Medicaid data. Study design Children ages 2-16 years who had a diagnosis of adenotonsillar hypertrophy (based on medical claim codes) in 2006 (n = 4276) were included in this population-based study. The main outcome was direct total costs paid by Medicaid. Costs 2 years before and after T&A were compared in children who underwent surgical intervention with those who did not as well as costs comparison pre- and post-T&A. Wilcoxon rank-sum or Wilcoxon Signed-rank test was used for costs comparisons. Results Children with adenotonsillar hypertrophy who underwent T&A were significantly less likely to be African American. They had more adenotonsillar infections before undergoing T&A and greater total costs (median costs $2313 vs $1945; P =.009). The median costs were $1228 pre-T&A, compared with $823 post-T&A (P <.0001). This reduction in costs of $405 (33%) compares with a median cost of the procedure of $1088. The reduction in costs was mostly because of less antibiotic use and outpatient visits. Conclusions African American children have fewer T&A procedures for adenotonsillar hypertrophy than white children, which represents an unexplained racial disparity. Children with adenotonsillar hypertrophy who underwent T&A compared with those who did not had more adenotonsillar infections and greater health care costs. T&A leads to a reduction in costs that, after 2 years, is 37% of the costs of the procedure. Future studies should examine the effects of demographics, obesity, and disease severity on health care costs in children with adenotonsillar hypertrophy.

Original languageEnglish (US)
Pages (from-to)1346-1351.e1
JournalJournal of Pediatrics
Volume164
Issue number6
DOIs
StatePublished - Jun 2014

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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