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[Cost effective and quality assured (adeno)tonsillectomy in children]
G Aasand1, H Miljeteig, H H Elverland
1Ore-nese-halsseksjonen, Kongsberg sykehus.
Insights
This study found no difference in patient satisfaction or surgical quality for pediatric adenotonsillectomies performed in public versus private clinics. Funding should be based on quality, not facility type.
Area of Science:
- Otorhinolaryngology
- Health Services Research
- Pediatric Surgery
Background:
- Ongoing debate in Norway regarding the provision and funding of minor surgical procedures.
- Focus on whether private or public clinics should perform these surgeries.
- Inclusion of national health service funding is a key consideration.
Purpose of the Study:
- To prospectively evaluate the benefits of adenotonsillectomies in children.
- To compare surgical outcomes and patient satisfaction between public and private healthcare settings.
- To inform policy decisions on healthcare funding for surgical procedures.
Main Methods:
- Prospective study involving 120 pediatric patients undergoing adenotonsillectomy.
- Surgery was conducted in both inpatient and outpatient settings.
- Procedures were performed in both public and private healthcare facilities.
Main Results:
- No significant differences in patient satisfaction or surgical quality were observed between public and private clinics.
- Consistent relief of symptoms related to adenotonsillar infections and obstruction post-surgery.
- Improved erythropoiesis indicated by increased hemoglobin and decreased erythrocyte protoporphyrin IX.
- Reduced manpower required for adenotonsillectomies in private compared to public clinics.
Conclusions:
- Surgical quality and patient outcomes for adenotonsillectomies are comparable across public and private settings.
- The Norwegian national health system should consider funding high-quality surgery regardless of the clinic type.
- Recommendations support funding based on established quality standards rather than facility ownership.
Background:
The issues of whether minor surgery should be performed in private or public clinics and/or be funded by the national health service are under continuous debate in Norway.
Material And Methods:
A prospective study of the benefit of (adeno)tonsillectomies in 120 children is presented. Surgery included in the study was performed on an inpatient as well as an outpatient basis and in public as well as private clinics.
Results:
There was no difference in patient satisfaction or in the quality of surgery depending on the type of organisation. Relief of symptoms associated with (adeno)tonsillar infections and obstruction following surgery was consistent. Less euresis was found in the study population following surgery. Increased haemoglobin concentration and less protoporfyrin IX in erythrocytes indicate an improved erythropoiesis following (adeno)tonsillectomy. Less manpower was needed to perform (adeno)tonsillectomies in private compared to public clinics.
Interpretation:
We suggest that the Norwegian national health system opens up for funding surgery of established quality irrespective of whether it is performed in a public or a private clinic.