Chung Shiu-Dong, Hung Shih-Han, Lin Herng-Ching, Chen Kuan-Chen
Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan; Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chung-Li, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taiwan.
Am J Otolaryngol. 2017 Jul-Aug;38(4):488-491. doi: 10.1016/j.amjoto.2017.05.004. Epub 2017 May 5.
This study attempted to investigate the effects of a tonsillectomy on utilization of medical resources for acute respiratory infections by comparing numbers and costs of clinic visits within 1year before and after a tonsillectomy.
Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. The study includes 481 patients aged 18-80years who underwent a tonsillectomy and 481 comparison patients. A multivariate regression model employing difference-in-difference was carried out to assess the independent association between a tonsillectomy and the number and costs of clinic visits.
We found that for patients who underwent a tonsillectomy, the mean number of clinic visits for acute respiratory care 1year before and after the index date significantly decreased from 7.3 to 4.2 (p<0.001). However, for the comparison group, there was no significant difference in the number (p=0.540) or costs (p=0.221) of clinic visits for acute respiratory care 1year before and after the index date. A multivariate regression model revealed that a tonsillectomy was associated with a reduction of 3.38 in the mean number of clinic visits for acute respiratory care (p<0.001). In other words, a tonsillectomy reduced by 46.3% (3.38/7.3) the number of clinic visits for acute respiratory care after adjusting for sociodemographic characteristics and medical comorbidities compared to comparison patients.
This study demonstrated that a tonsillectomy was of substantial benefit to adult patients in that it provides decreased healthcare utilization for acute respiratory infections.
本研究试图通过比较扁桃体切除术前1年和术后1年的门诊就诊次数及费用，探讨扁桃体切除术对急性呼吸道感染医疗资源利用的影响。
本研究数据取自2005年台湾纵向健康保险数据库。该研究纳入了481例年龄在18 - 80岁之间接受扁桃体切除术的患者以及481例对照患者。采用差分法进行多变量回归模型分析，以评估扁桃体切除术与门诊就诊次数及费用之间的独立关联。
我们发现，接受扁桃体切除术的患者，在索引日期前后1年，急性呼吸道护理的平均门诊就诊次数从7.3次显著降至4.2次（p<0.001）。然而，对于对照组，在索引日期前后1年，急性呼吸道护理的门诊就诊次数（p = 0.540）或费用（p = 0.221）均无显著差异。多变量回归模型显示，扁桃体切除术与急性呼吸道护理的平均门诊就诊次数减少3.38次相关（p<0.001）。换句话说，与对照患者相比，在调整社会人口统计学特征和医疗合并症后，扁桃体切除术使急性呼吸道护理的门诊就诊次数减少了46.3%（3.38/7.3）。
本研究表明，扁桃体切除术对成年患者有显著益处，因为它减少了急性呼吸道感染的医疗保健利用。
