Does Adenotonsillectomy Reduce Total Health Care Costs of Adenotonsillar Hypertrophy?

F. Bruder Stapleton, MD

The procedure reduced postsurgical costs but was associated with greater total health care costs.

Adenotonsillectomy is a common intervention for pediatric adenotonsillar hypertrophy with disordered sleep. To evaluate its cost-effectiveness, researchers reviewed 4 years (2004–2008) of Missouri Medicaid claims for 4276 children (age range, 2–16 years) diagnosed with adenotonsillar hypertrophy; 2915 (68%) underwent adenotonsillectomy in 2006.

Compared with children who did not undergo adenotonsillectomy, children who did were more likely to be white, older, and five times more likely to have tonsillar infections before the procedure. Median 4-year total cost was significantly higher (15%) in the adenotonsillectomy group (US$2313 vs. $1945). Median costs during the 2 years before and after adenotonsillectomy were $1228 and $838, respectively, and the median cost of adenotonsillectomy was $1088. Reductions in postsurgical costs were related to fewer antibiotic prescriptions and patient visits.

Citation(s):

Chang JJ et al. Cost analysis of tonsillectomy in children using Medicaid data. J Pediatr 2014 Mar 14; [e-pub ahead of print].