Caregiver-Reported Outcomes and Indirect Costs of Pediatric Tonsillectomy

Abstract

Objectives:

(1) Obtain caregiver reported outcomes including number of missed work days (caregivers) and school (child) after tonsillectomy or adenotonsillectomy (T&A). (2) Quantify the indirect costs associated with caring for a child after T&A.

Methods:

A telephone survey was conducted of caregivers of children from a pediatric otolaryngology clinic who underwent T&A from October 2013 to January 2014. Caregivers were surveyed 2 to 5 weeks after surgery. Information obtained included number of postoperative days the child had symptoms, number of missed school and work days, and caregivers out of pockets costs for medical expenses, child care, and work absence.

Results:

Surveys were attempted with caregivers of 141 pediatric patients and 53 completed surveys were obtained, for a response rate of 37.6%. Mean patient age was 6.1 ± 3.9 years. Patient symptoms persisted for a mean of 10.8 ± 4.4 days after surgery. On average, patients returned to normal activity at 10.1 ± 4.8 days and normal diet at 11.3 ± 5.7 days. The average school absence was 10.0 ± 6.6 days. A total of 38 of 53 (71.7%) caregivers required time off work with a mean work absence of 4.9 ± 3.9 days. The mean income loss (for those missing work) per T&A was $626 ± 444. The combined income loss for the caregivers was $21,922.

Conclusions:

Indirect costs of pediatric T&A are significant due to missed school and loss of income from employment absence. The caregiver reported outcomes and indirect costs measured in this survey could be used in future studies to compare the effectiveness of different tonsillectomy techniques or postoperative pain management protocols.