Resource analysis of tonsillectomy in children

Udayan K. Shah, Zachary Theroux, Gopi B. Shah, William J. Parkes, Christine Schuck

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objectives/Hypothesis To analyze variables that affect time and cost parameters of pediatric adenotonsillectomy. Study Design Longitudinal 7-month retrospective review of sequential tonsil and adenoid surgery at a university pediatric tertiary care hospital. Methods 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. Results 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). Conclusions 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.

Original languageEnglish (US)
Pages (from-to)1223-1228
Number of pages6
JournalLaryngoscope
Volume124
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Cost containment
  • medical economics
  • sleep apnea
  • tonsillitis

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Shah, U. K., Theroux, Z., Shah, G. B., Parkes, W. J., & Schuck, C. (2014). Resource analysis of tonsillectomy in children. Laryngoscope, 124(5), 1223-1228. https://doi.org/10.1002/lary.24388