Direct listing for adult tonsillectomy.
Health care economic efficiency is important. Adult tonsillectomy is a common operation. The decision to operate is made at an out-patient consultation and is based on information in the general practitioner's (GP) referral letter. This study aims to define what proportion of adult tonsillectomies are suitable for listing with an out-patient consultation (direct listing). GPs were informed of the indications (six episodes of tonsillitis in the last year) and contraindications (tonsillectomy for another reason and general ill health) for direct listing. All referrals for 1 year were screened by an otolaryngologist and suitable patients were listed directly. Patients were then reviewed in the anaesthetic pre-admission clinic and inappropriate listings were cancelled and reasons noted. Of all patients, 50% were suitable for direct listing. Of these 3% were later deemed inappropriate. None of the cancellations were due to a flaw in the direct listing process. This would result in savings to the NHS of 2 million pounds per annum.
Shah
C
C
Department of Otolaryngology, St Michael's Hospital, Bristol, UK.
Griffiths
M
M
Moralee
S
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000758:Anesthesia; D000075202:Contraindications; D017046:Cost Savings; D003657:Decision Making; D004194:Disease; D004739:England / Q000453:epidemiology; D005194:Family Practice; D006801:Humans; D010036:Otolaryngology; D010343:Patient Admission; D018579:Patient Selection; D012008:Recurrence; D012017:Referral and Consultation; D013222:State Medicine / Q000191:economics; D014068:Tonsillectomy / Q000191:economics / Q000706:statistics & numerical data; D014069:Tonsillitis / Q000601:surgery