Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
JAMA Otolaryngol Head Neck Surg. 2013 Feb;139(2):129-33. doi: 10.1001/jamaoto.2013.1324.
To compare the costs associated with 2 clinical strategies in children with recurrent upper respiratory tract infections (URTIs): immediate adenoidectomy vs an initial watchful waiting strategy.
A cost-minimization analysis from a societal perspective including both direct and indirect costs, alongside an open randomized controlled trial with a 2-year follow-up.
Multicenter study, including 11 general and 2 university hospitals in the Netherlands.
The study population comprised 111 children aged 1 through 6 years, selected for adenoidectomy for recurrent URTIs according to current clinical practice.
A strategy of immediate adenoidectomy with or without myringotomy or a strategy of initial watchful waiting.
Difference in median costs during the 2-year follow-up.
The median total of direct and indirect costs in the adenoidectomy and watchful waiting group were €1385 (US $1995) and €844 (US $1216) per patient, respectively. The extra costs in the adenoidectomy group are primarily attributable to surgery and visits to the otorhinolaryngologist. Other costs did not differ significantly between the groups.
In children selected for adenoidectomy for recurrent URTIs, immediate adenoidectomy results in an increase in costs, whereas it confers no clinical benefit over an initial watchful waiting strategy.
trialregister.nl Identifier:NTR968; isrctn.org Identifier:ISRCTN03720485.
比较 2 种临床策略在儿童复发性上呼吸道感染（URTIs）中的成本：立即腺样体切除术与初始观察等待策略。
从社会角度进行成本最小化分析，包括直接和间接成本，同时进行开放随机对照试验，随访 2 年。
荷兰 11 家综合医院和 2 家大学医院的多中心研究。
研究人群包括 111 名 1 至 6 岁的儿童，根据当前临床实践选择腺样体切除术治疗复发性 URTIs。
立即行腺样体切除术，伴或不伴鼓膜切开术，或行初始观察等待策略。
2 年随访期间的中位成本差异。
腺样体切除术和观察等待组的直接和间接总成本中位数分别为€1385（US $1995）和€844（US $1216）/患者。腺样体切除术组的额外成本主要归因于手术和耳鼻喉科就诊。两组其他成本无显著差异。
在因复发性 URTIs 而选择行腺样体切除术的儿童中，与初始观察等待策略相比，立即行腺样体切除术增加了成本，但并未带来临床获益。
trialregister.nl 标识符：NTR968；isrctn.org 标识符：ISRCTN03720485。
