Related Experiment Video
Updated: Nov 28, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Changes in healthcare utilisation for paediatric tonsillectomy and adenoidectomy in the Netherlands: a
Juliëtte J C M van Munster1,2, Amir H Zamanipoor Najafabadi2, Janneke van 't Hooft3
1Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Insights
Paediatric tonsil surgery rates in the Netherlands decreased significantly following a quality improvement initiative. This led to substantial savings in healthcare and societal costs.
Area of Science:
- Otolaryngology
- Health Services Research
- Pediatric Surgery
Background:
- Tonsillectomy and adenoidectomy rates in children show significant regional variation.
- Lack of high-quality evidence contributes to differing surgical indications.
- A quality of care cycle was implemented in the Netherlands to address these issues.
Purpose of the Study:
- To estimate changes in healthcare utilization for pediatric tonsil surgery in the Netherlands.
- To evaluate the impact of a quality of care cycle on surgical rates and costs.
Main Methods:
- Retrospective analysis of population-based data on pediatric tonsillectomies and adenoidectomies (2005-2018).
- Change point analysis to identify shifts in surgical rates.
- Univariate analyses to compare patient characteristics before and after the pivotal change point.
- Estimation of healthcare budget and societal cost impacts.
Main Results:
- Annual adenotonsillectomies decreased by 39% (10,952 procedures).
- Annual adenoidectomies decreased by 49% (14,757 procedures).
- A pivotal change point in surgical rates was identified around 2012.
- Annual savings of €5.3 million on the healthcare budget and €10.4 million on societal costs were estimated.
Conclusions:
- The quality of care cycle effectively reduced the number of pediatric tonsil surgeries.
- Significant cost reductions were observed in both healthcare and societal expenses.
- Investment in further research is recommended to sustain quality improvements.
Objectives:
Tonsillectomy and adenoidectomy in children are controversial subjects with large regional variation in surgical rates, partly explained by cultural differences and lack of high-quality evidence on indications for surgery. A quality of care cycle was executed on this topic in the Netherlands. The objective of this study was to estimate changes in healthcare utilisation for paediatric tonsil surgery in the Netherlands.
Methods:
Population-based data on tonsillectomies and adenoidectomies in children up to age 10 were retrieved retrospectively from Dutch administrative databases between 2005 and 2018. A change point analysis was performed to detect the most pivotal change point in surgical rates. We performed univariate analyses to compare surgical patients' characteristics before and after the pivotalpoint . Impact on healthcare budget and societal costs were estimated using current prices and data from cost-effectiveness analyses.
Results:
The annual number of adenotonsillectomies reduced by 10 952 procedures (-39%; from 129 per 10 000 children to 87 per 10 000 children) between 2005 and 2018, and the number of adenoidectomies by 14 757 procedures (-49%; from 138 per 10 000 children to 78 per 10 000 children). The most pivotal change point was observed around 2012, accompanied by small changes in patient selection for surgery before and after 2012. An estimated €5.3 million per year was saved on the healthcare budget and €10.4 million per year on societal costs.
Conclusion:
The quality of care cycle resulted in fewer operations, with a concomitant reduction of costs. We suggest that part of these savings be invested in new research to maintain the quality of care cycle.
More Related Videos
07:38Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue
Published on: June 14, 2020
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Related Concept Videos
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:26Tonsillitis II: Management
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:29Suctioning the Nasopharyngeal Airway
Equipment Required