TY - JOUR
T1 - Estimations of Inpatient and Ambulatory Pediatric Tonsillectomy in the United States
T2 - A Cross-sectional Analysis
AU - Johnson, Romaine F.
AU - Zhang, Jinghan
AU - Chorney, Stephen R.
AU - Kou, Yann Fuu
AU - Lenes-Voit, Felicity
AU - Ulualp, Seckin
AU - Liu, Christopher
AU - Mitchell, Ron B.
N1 - Publisher Copyright:
© 2023 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
PY - 2023/8
Y1 - 2023/8
N2 - Objective: To estimate the incidence of inpatient and ambulatory pediatric tonsillectomies in the United States in 2019. Study Design: Cross-sectional analysis. Setting: Healthcare Cost and Utilization Project databases. Methods: We determined national incidences of hospital-based ambulatory procedures, inpatient admissions, and readmissions among pediatric tonsillectomy patients, ages 0 to 20 years, using the Kids Inpatient Database, Nationwide Ambulatory Surgery Sample, and Nationwide Readmission Database. We described the demographics, commonly associated conditions, complications, and predictors of readmission. Results: An estimated 559,900 ambulatory and 7100 inpatient tonsillectomies were performed in 2019. Among inpatients, the majority were male (59%) and the largest ethnic group was white (37%). Adenotonsillar hypertrophy (ATH), 79%, and obstructive sleep apnea (OSA), 74%, were the most frequent diagnosis and Medicaid (61%) was the most frequent primary payer. The majority of ambulatory tonsillectomy patients were female (52%) and white (65%); ATH, OSA, and Medicaid accounted for 62%, 29%, and 45% of cases, respectively, (all p <.001 when compared to inpatient cases). Common inpatient complications were bleeding (2%), pain/nausea/vomiting (5.6%), and postprocedural respiratory failure (1.7%). On the other hand, ambulatory complications occurred in less than 1% of patients. The readmission rate was 5.2%, with pain/nausea/vomiting and bleeding accounting for 35% and 23% of overall readmissions. All Patient Refined Diagnosis Related Groups severity of illness subclass predicted readmission (odds ratio = 2.18, 95% confidence interval = 1.73-2.73, p <.001). Conclusion: A total of 567,000 pediatric ambulatory and inpatient tonsillectomies were performed in 2019; the majority were performed in ambulatory settings. The index admission severity of illness was associated with readmission risk.
AB - Objective: To estimate the incidence of inpatient and ambulatory pediatric tonsillectomies in the United States in 2019. Study Design: Cross-sectional analysis. Setting: Healthcare Cost and Utilization Project databases. Methods: We determined national incidences of hospital-based ambulatory procedures, inpatient admissions, and readmissions among pediatric tonsillectomy patients, ages 0 to 20 years, using the Kids Inpatient Database, Nationwide Ambulatory Surgery Sample, and Nationwide Readmission Database. We described the demographics, commonly associated conditions, complications, and predictors of readmission. Results: An estimated 559,900 ambulatory and 7100 inpatient tonsillectomies were performed in 2019. Among inpatients, the majority were male (59%) and the largest ethnic group was white (37%). Adenotonsillar hypertrophy (ATH), 79%, and obstructive sleep apnea (OSA), 74%, were the most frequent diagnosis and Medicaid (61%) was the most frequent primary payer. The majority of ambulatory tonsillectomy patients were female (52%) and white (65%); ATH, OSA, and Medicaid accounted for 62%, 29%, and 45% of cases, respectively, (all p <.001 when compared to inpatient cases). Common inpatient complications were bleeding (2%), pain/nausea/vomiting (5.6%), and postprocedural respiratory failure (1.7%). On the other hand, ambulatory complications occurred in less than 1% of patients. The readmission rate was 5.2%, with pain/nausea/vomiting and bleeding accounting for 35% and 23% of overall readmissions. All Patient Refined Diagnosis Related Groups severity of illness subclass predicted readmission (odds ratio = 2.18, 95% confidence interval = 1.73-2.73, p <.001). Conclusion: A total of 567,000 pediatric ambulatory and inpatient tonsillectomies were performed in 2019; the majority were performed in ambulatory settings. The index admission severity of illness was associated with readmission risk.
KW - Healthcare Cost and Utilization Project
KW - cross-sectional analysis
KW - incidence
KW - pediatric tonsillectomy
UR - http://www.scopus.com/inward/record.url?scp=85165546450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85165546450&partnerID=8YFLogxK
U2 - 10.1002/ohn.268
DO - 10.1002/ohn.268
M3 - Article
C2 - 36939461
AN - SCOPUS:85165546450
SN - 0194-5998
VL - 169
SP - 258
EP - 266
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -