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Indirect costs related to caregivers' absence from work after paediatric tonsil surgery

Journal article
Authors Gunhildur Gudnadottir
G. R. Tennvall
Joacim Stalfors
Johan Hellgren
Published in European Archives of Oto-Rhino-Laryngology
Volume 274
Issue 6
Pages 2629-2636
ISSN 0937-4477
Publication year 2017
Published at Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Otorhinolaryngology
Pages 2629-2636
Language English
Links 10.1007/s00405-017-4526-7
Keywords Tonsillectomy, Tonsillotomy, Absenteeism, Indirect cost, Health economy, obstructive sleep-apnea, children, adenotonsillectomy, tonsillectomy, sweden
Subject categories Otorhinolaryngology

Abstract

Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers' absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1-11 were included, n = 4534. The number of days the child needed analgesics after surgery was used as a proxy to estimate the number of work days lost for the caregiver. Data from the Social Insurance Agency (Forsakringskassan) regarding the days the parents received temporary parental benefits in the month following surgery were also analysed. The indirect costs due to the caregivers' absenteeism after tonsillectomy vs tonsillotomy were calculated, using the human capital method. The patient-reported use of postoperative analgesic use was 77% (n = 3510). Data from the Social Insurance Agency were gathered for all 4534 children. The mean duration of analgesic treatment was 4.6 days (indirect cost of EUR 747). The mean number of days with parental benefits was 2.9 (EUR 667). The indirect cost of tonsillectomy was 61% higher than that of tonsillotomy (EUR 1010 vs EUR 629). The results show that the choice of surgical method affects the indirect costs, favouring the use of tonsillotomy over tonsillectomy for the treatment of children with SDB, due to less postoperative pain.

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