Factors contributing to cost in partial versus total tonsillectomy
Objectives/Hypothesis To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors we...
Gespeichert in:
| Veröffentlicht in: | The Laryngoscope 2013-11, Vol.123 (11), p.2868-2872 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2872 |
|---|---|
| container_issue | 11 |
| container_start_page | 2868 |
| container_title | The Laryngoscope |
| container_volume | 123 |
| creator | Stucken, Emily Z. Grunstein, Eli Haddad Jr, Joseph Modi, Vikash K. Waldman, Erik H. Ward, Robert F. Stewart, Michael G. April, Max M. |
| description | Objectives/Hypothesis
To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors were examined.
Study Design
Retrospective review at two university‐based tertiary care hospitals from January 2007 to June 2010.
Methods
Pediatric patients with obstructive symptoms were divided into those undergoing total tonsillectomy and those undergoing partial intracapsular tonsillectomy. The records of 289 patients who underwent total tonsillectomy and 289 patients who underwent partial intracapsular tonsillectomy were reviewed.
Results
The average age of patients undergoing total and partial tonsillectomies was 5.0 years for both groups. Significant differences for patients undergoing total versus partial tonsillectomies were as follows: operative time (32.4 vs. 26.4 minutes, P |
| doi_str_mv | 10.1002/lary.24025 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1447106250</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1447106250</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3955-ac8f7996212df8ebb9230b5bb28a6cdea01b0fdab968abfebeb4498b71c3f63f3</originalsourceid><addsrcrecordid>eNp9kE1LAzEURYMoWqsbf4AMuBFhNB-TyWSp1VahKFSlugrJTEai81GTjNp_b2pbFy5cPR7v3MvjAHCA4CmCEJ9V0s5PcQIx3QA9RAmKE87pJuiFI4kzip92wK5zrxAiRijcBjuYUMwznvbAxVDmvrUuytvGW6M6b5qXyLdhdz4yTTST1htZRR_aus6Fiw-LbxtnqkqHaD3fA1ulrJzeX80-eBxePQyu4_Hd6GZwPo5zwimNZZ6VjPMUI1yUmVaKYwIVVQpnMs0LLSFSsCyk4mkmVamVVknCM8VQTsqUlKQPjpe9M9u-d9p5URuX66qSjW47J1CSMARTTGFAj_6gr21nm_BdoBiGKCNsQZ0sqdy2zlldipk1dZApEBQLs2JhVvyYDfDhqrJTtS5-0bXKAKAl8GkqPf-nSozPJ8_r0niZMc7rr9-MtG8iZYRRMb0diUEyndwzdikeyDdek5Of</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1472018370</pqid></control><display><type>article</type><title>Factors contributing to cost in partial versus total tonsillectomy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Stucken, Emily Z. ; Grunstein, Eli ; Haddad Jr, Joseph ; Modi, Vikash K. ; Waldman, Erik H. ; Ward, Robert F. ; Stewart, Michael G. ; April, Max M.</creator><creatorcontrib>Stucken, Emily Z. ; Grunstein, Eli ; Haddad Jr, Joseph ; Modi, Vikash K. ; Waldman, Erik H. ; Ward, Robert F. ; Stewart, Michael G. ; April, Max M.</creatorcontrib><description><![CDATA[Objectives/Hypothesis
To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors were examined.
Study Design
Retrospective review at two university‐based tertiary care hospitals from January 2007 to June 2010.
Methods
Pediatric patients with obstructive symptoms were divided into those undergoing total tonsillectomy and those undergoing partial intracapsular tonsillectomy. The records of 289 patients who underwent total tonsillectomy and 289 patients who underwent partial intracapsular tonsillectomy were reviewed.
Results
The average age of patients undergoing total and partial tonsillectomies was 5.0 years for both groups. Significant differences for patients undergoing total versus partial tonsillectomies were as follows: operative time (32.4 vs. 26.4 minutes, P < .0001), postanesthesia care unit (PACU) time (174 vs. 91.6 minutes, P < .0001), percent admitted postoperatively (21.5% vs. 1.7%, P < .0001), number requiring pediatric intensive care unit stay (3.5% vs. 0.3%, P < .05), number of readmissions after discharge (3.5% vs. 0.3%, P < .05), and number of postoperative emergency room visits separate from those requiring readmission (4.8% vs. 0%, P < .05). Factors that were not found to be significantly different included number of patients with postoperative hemorrhage and number requiring second operations for tonsillar regrowth.
Conclusions
Previous studies have shown equivalent effectiveness between these two procedures; our study suggests decreased cost and resource utilization with partial tonsillectomy through reduced operative and PACU times and number of postoperative admissions and emergency department visits. As in all retrospective reviews, the findings are potentially confounded by unmeasured variables, including patient and demographic factors.
Level of Evidence
4. Laryngoscope, 123:2868–2872, 2013]]></description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.24025</identifier><identifier>PMID: 23529896</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Child ; Child, Preschool ; complete tonsillectomy ; cost analysis ; Costs and Cost Analysis ; Emergency medical care ; Female ; Hospitals ; Humans ; Infant ; Male ; obstructive sleep apnea ; partial intracapsular tonsillectomy ; Pediatrics ; Perioperative Care ; Retrospective Studies ; sleep disordered breathing ; Tonsillectomy - economics ; Tonsillectomy - methods ; Total tonsillectomy</subject><ispartof>The Laryngoscope, 2013-11, Vol.123 (11), p.2868-2872</ispartof><rights>Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3955-ac8f7996212df8ebb9230b5bb28a6cdea01b0fdab968abfebeb4498b71c3f63f3</citedby><cites>FETCH-LOGICAL-c3955-ac8f7996212df8ebb9230b5bb28a6cdea01b0fdab968abfebeb4498b71c3f63f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.24025$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.24025$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23529896$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stucken, Emily Z.</creatorcontrib><creatorcontrib>Grunstein, Eli</creatorcontrib><creatorcontrib>Haddad Jr, Joseph</creatorcontrib><creatorcontrib>Modi, Vikash K.</creatorcontrib><creatorcontrib>Waldman, Erik H.</creatorcontrib><creatorcontrib>Ward, Robert F.</creatorcontrib><creatorcontrib>Stewart, Michael G.</creatorcontrib><creatorcontrib>April, Max M.</creatorcontrib><title>Factors contributing to cost in partial versus total tonsillectomy</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description><![CDATA[Objectives/Hypothesis
To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors were examined.
Study Design
Retrospective review at two university‐based tertiary care hospitals from January 2007 to June 2010.
Methods
Pediatric patients with obstructive symptoms were divided into those undergoing total tonsillectomy and those undergoing partial intracapsular tonsillectomy. The records of 289 patients who underwent total tonsillectomy and 289 patients who underwent partial intracapsular tonsillectomy were reviewed.
Results
The average age of patients undergoing total and partial tonsillectomies was 5.0 years for both groups. Significant differences for patients undergoing total versus partial tonsillectomies were as follows: operative time (32.4 vs. 26.4 minutes, P < .0001), postanesthesia care unit (PACU) time (174 vs. 91.6 minutes, P < .0001), percent admitted postoperatively (21.5% vs. 1.7%, P < .0001), number requiring pediatric intensive care unit stay (3.5% vs. 0.3%, P < .05), number of readmissions after discharge (3.5% vs. 0.3%, P < .05), and number of postoperative emergency room visits separate from those requiring readmission (4.8% vs. 0%, P < .05). Factors that were not found to be significantly different included number of patients with postoperative hemorrhage and number requiring second operations for tonsillar regrowth.
Conclusions
Previous studies have shown equivalent effectiveness between these two procedures; our study suggests decreased cost and resource utilization with partial tonsillectomy through reduced operative and PACU times and number of postoperative admissions and emergency department visits. As in all retrospective reviews, the findings are potentially confounded by unmeasured variables, including patient and demographic factors.
Level of Evidence
4. Laryngoscope, 123:2868–2872, 2013]]></description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>complete tonsillectomy</subject><subject>cost analysis</subject><subject>Costs and Cost Analysis</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>obstructive sleep apnea</subject><subject>partial intracapsular tonsillectomy</subject><subject>Pediatrics</subject><subject>Perioperative Care</subject><subject>Retrospective Studies</subject><subject>sleep disordered breathing</subject><subject>Tonsillectomy - economics</subject><subject>Tonsillectomy - methods</subject><subject>Total tonsillectomy</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEURYMoWqsbf4AMuBFhNB-TyWSp1VahKFSlugrJTEai81GTjNp_b2pbFy5cPR7v3MvjAHCA4CmCEJ9V0s5PcQIx3QA9RAmKE87pJuiFI4kzip92wK5zrxAiRijcBjuYUMwznvbAxVDmvrUuytvGW6M6b5qXyLdhdz4yTTST1htZRR_aus6Fiw-LbxtnqkqHaD3fA1ulrJzeX80-eBxePQyu4_Hd6GZwPo5zwimNZZ6VjPMUI1yUmVaKYwIVVQpnMs0LLSFSsCyk4mkmVamVVknCM8VQTsqUlKQPjpe9M9u-d9p5URuX66qSjW47J1CSMARTTGFAj_6gr21nm_BdoBiGKCNsQZ0sqdy2zlldipk1dZApEBQLs2JhVvyYDfDhqrJTtS5-0bXKAKAl8GkqPf-nSozPJ8_r0niZMc7rr9-MtG8iZYRRMb0diUEyndwzdikeyDdek5Of</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Stucken, Emily Z.</creator><creator>Grunstein, Eli</creator><creator>Haddad Jr, Joseph</creator><creator>Modi, Vikash K.</creator><creator>Waldman, Erik H.</creator><creator>Ward, Robert F.</creator><creator>Stewart, Michael G.</creator><creator>April, Max M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Factors contributing to cost in partial versus total tonsillectomy</title><author>Stucken, Emily Z. ; Grunstein, Eli ; Haddad Jr, Joseph ; Modi, Vikash K. ; Waldman, Erik H. ; Ward, Robert F. ; Stewart, Michael G. ; April, Max M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3955-ac8f7996212df8ebb9230b5bb28a6cdea01b0fdab968abfebeb4498b71c3f63f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>complete tonsillectomy</topic><topic>cost analysis</topic><topic>Costs and Cost Analysis</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>obstructive sleep apnea</topic><topic>partial intracapsular tonsillectomy</topic><topic>Pediatrics</topic><topic>Perioperative Care</topic><topic>Retrospective Studies</topic><topic>sleep disordered breathing</topic><topic>Tonsillectomy - economics</topic><topic>Tonsillectomy - methods</topic><topic>Total tonsillectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stucken, Emily Z.</creatorcontrib><creatorcontrib>Grunstein, Eli</creatorcontrib><creatorcontrib>Haddad Jr, Joseph</creatorcontrib><creatorcontrib>Modi, Vikash K.</creatorcontrib><creatorcontrib>Waldman, Erik H.</creatorcontrib><creatorcontrib>Ward, Robert F.</creatorcontrib><creatorcontrib>Stewart, Michael G.</creatorcontrib><creatorcontrib>April, Max M.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stucken, Emily Z.</au><au>Grunstein, Eli</au><au>Haddad Jr, Joseph</au><au>Modi, Vikash K.</au><au>Waldman, Erik H.</au><au>Ward, Robert F.</au><au>Stewart, Michael G.</au><au>April, Max M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors contributing to cost in partial versus total tonsillectomy</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2013-11</date><risdate>2013</risdate><volume>123</volume><issue>11</issue><spage>2868</spage><epage>2872</epage><pages>2868-2872</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract><![CDATA[Objectives/Hypothesis
To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors were examined.
Study Design
Retrospective review at two university‐based tertiary care hospitals from January 2007 to June 2010.
Methods
Pediatric patients with obstructive symptoms were divided into those undergoing total tonsillectomy and those undergoing partial intracapsular tonsillectomy. The records of 289 patients who underwent total tonsillectomy and 289 patients who underwent partial intracapsular tonsillectomy were reviewed.
Results
The average age of patients undergoing total and partial tonsillectomies was 5.0 years for both groups. Significant differences for patients undergoing total versus partial tonsillectomies were as follows: operative time (32.4 vs. 26.4 minutes, P < .0001), postanesthesia care unit (PACU) time (174 vs. 91.6 minutes, P < .0001), percent admitted postoperatively (21.5% vs. 1.7%, P < .0001), number requiring pediatric intensive care unit stay (3.5% vs. 0.3%, P < .05), number of readmissions after discharge (3.5% vs. 0.3%, P < .05), and number of postoperative emergency room visits separate from those requiring readmission (4.8% vs. 0%, P < .05). Factors that were not found to be significantly different included number of patients with postoperative hemorrhage and number requiring second operations for tonsillar regrowth.
Conclusions
Previous studies have shown equivalent effectiveness between these two procedures; our study suggests decreased cost and resource utilization with partial tonsillectomy through reduced operative and PACU times and number of postoperative admissions and emergency department visits. As in all retrospective reviews, the findings are potentially confounded by unmeasured variables, including patient and demographic factors.
Level of Evidence
4. Laryngoscope, 123:2868–2872, 2013]]></abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23529896</pmid><doi>10.1002/lary.24025</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0023-852X |
| ispartof | The Laryngoscope, 2013-11, Vol.123 (11), p.2868-2872 |
| issn | 0023-852X 1531-4995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1447106250 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Child Child, Preschool complete tonsillectomy cost analysis Costs and Cost Analysis Emergency medical care Female Hospitals Humans Infant Male obstructive sleep apnea partial intracapsular tonsillectomy Pediatrics Perioperative Care Retrospective Studies sleep disordered breathing Tonsillectomy - economics Tonsillectomy - methods Total tonsillectomy |
| title | Factors contributing to cost in partial versus total tonsillectomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T13%3A06%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Factors%20contributing%20to%20cost%20in%20partial%20versus%20total%20tonsillectomy&rft.jtitle=The%20Laryngoscope&rft.au=Stucken,%20Emily%20Z.&rft.date=2013-11&rft.volume=123&rft.issue=11&rft.spage=2868&rft.epage=2872&rft.pages=2868-2872&rft.issn=0023-852X&rft.eissn=1531-4995&rft_id=info:doi/10.1002/lary.24025&rft_dat=%3Cproquest_cross%3E1447106250%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1472018370&rft_id=info:pmid/23529896&rfr_iscdi=true |