Leupe P, Hox V, Debruyne F, Schrooten W, Claes N V, Lemkens N, Lemkens P
Department of Otorhinolaryngology, Head and Neck surgery, Ziekenhuis Oost Limburg, Genk, Belgium.
B-ENT. 2012;8(2):103-11.
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.
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.
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 613 Euros (NIS) or 759 Euros (FOD) for acute tonsillitis and 435 Euros (NIS) or 539 Euros (FOD) for a tonsillectomy. The medical costs linked to the surgical procedure at the local department correspond to 535 Euros and for an acute tonsillitis to 46 Euros.
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.
扁桃体切除术是儿童中最常施行的外科手术之一；其主要适应症为急性扁桃体炎反复发作和腺样体扁桃体肥大。扁桃体切除术对严重复发性扁桃体炎的有效性已得到普遍认可；然而，其社会经济成本的研究较少。本研究旨在确定并比较扁桃体切除术和严重咽喉感染的社会成本。
评估了扁桃体切除术和严重咽喉感染的成本。根据参与研究医院的资源使用和人员投入计算手术过程及住院费用。基于275名接受扁桃体切除术患儿的家长填写的问卷来衡量两种治疗方法导致的与工作相关的残疾成本。使用来自比利时两个机构（国家疾病保险研究所和联邦劳动、就业与社会对话部）的数据来计算家长缺勤的成本。
与扁桃体切除术（2.2±0.2天）相比，儿童急性扁桃体炎发作导致家长更长时间的缺勤（平均3.1±0.3天）。急性扁桃体炎导致的经济生产力损失成本为613欧元（国家疾病保险研究所数据）或759欧元（联邦劳动、就业与社会对话部数据），扁桃体切除术导致的经济生产力损失成本为435欧元（国家疾病保险研究所数据）或539欧元（联邦劳动、就业与社会对话部数据）。当地科室与手术相关的医疗费用为535欧元，急性扁桃体炎的医疗费用为46欧元。
从社会角度来看，扁桃体切除术的成本相当于严重咽喉感染成本的1.4倍。这表明，对于患有复发性急性扁桃体炎的儿童，考虑到家长缺勤的累积成本，密切观察等待比扁桃体切除术成本更高。
