[Tonsillectomy in a day care hospital. A socioeconomic study at the Robert Debré Hospital in Paris].
Tonsillectomy as an outpatient procedure in children is a common practice in the United States and many other countries. In French public hospitals, it remains quite rare. A 6-month prospective study was conducted in order to check the procedure's feasibility in a large Paris university children's hospital, to describe the involved population and to search for the possible benefits which could be made by a public hospital from an increase in day surgery practice for tonsillectomy. In terms of quality of postoperative outcome, this study confirms the absence of major complications related to this procedure if the proper criteria are met for day surgery. In fact, medical and social findings from the involved patients tend to limit here a large extension of this procedure. For example, in the inpatients group, more than 43% of children had a tonsillar hypertrophy with significant airway obstruction and 47% did not have lodging conditions which would allow day surgery with the required safety. Only 20% of patients could be transferred to ambulatory surgery which leads to 2-3 additional cases each week here. Finally, the cost analysis shows no benefit in human resources at this hospital because the requested differential activity threshold would not be reached.
Contencin
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P
Service d'ORL, Hôpital Robert-Debré, Paris.
de Gaudemar
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I
Falala
M
M
Benzekri
P
P
Fontaine
A
A
Narcy
P
P
D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003631:Day Care, Medical / Q000191:economics* / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010297:Paris; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods
L'amygdalectomie en hôpital de jour. Etude socio-économique à l'hôpital Robert-Debré de Paris.