title: Impact of tonsillectomy on health-related quality of life and healthcare costs in children and adolescents.
abstract: BACKGROUND
  Tonsillectomy is a common surgical intervention in children, but its efficacy is under debate. We studied whether tonsillectomy is a cost-effective intervention with a positive impact on health-related quality of life (HRQoL).
  
  
  METHODS
  Children (aged 7-11 years) and adolescents (aged 12-15 years) undergoing tonsillectomy answered the 17D or 16D HRQoL questionnaires before tonsillectomy and at 6 and 12 months postoperatively. At the same time-points, data on the use of healthcare services and school absenteeism were collected by questionnaire.
  
  
  RESULTS
  Altogether 49 children and 42 adolescents returned all HRQoL questionnaires. Tonsillectomy improved the mean total HRQoL score clinically and statistically significantly in both children (from 0.935 at baseline to 0.958 at 12 months, p = 0.002) and adolescents (from 0.930 to 0.957, p = 0.004). The mean direct self-reported healthcare service costs diminished after tonsillectomy in both groups. The mean number of days on sick leave due to oropharyngeal problems during the preceding 3 months decreased from the preoperative 4.6 days to postoperative 0.5 days (p < 0.001) in children, and from 4.9 days to 0.8 days (p < 0.001) in adolescents at 12 months.
  
  
  CONCLUSIONS
  Tonsillectomy improves HRQoL in both school-aged children and adolescents and reduces healthcare service needs and school absenteeism due to oropharyngeal symptoms.
authors.affiliation: Department of Otorhinolaryngology, Helsinki University Central Hospital, P.O. Box 220, 00029, HUS, Helsinki, Finland. Electronic address: johanna.nokso-koivisto@hus.fi.
authors.forename: Johanna
authors.initials: J
authors.lastname: Nokso-Koivisto
authors.affiliation: Department of Otorhinolaryngology, Helsinki University Central Hospital, P.O. Box 220, 00029, HUS, Helsinki, Finland. Electronic address: karin.blomgren@hus.fi.
authors.forename: Karin
authors.initials: K
authors.lastname: Blomgren
authors.affiliation: Helsinki and Uusimaa Hospital Group, Group Administration, P.O. Box 705, 00029 HUS, Helsinki, Finland. Electronic address: risto.p.roine@hus.fi.
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.affiliation: Department of Public Health, Hjelt Institute, P.O. Box 41, 00014, University of Helsinki, Helsinki, Finland. Electronic address: harri.sintonen@helsinki.fi.
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.affiliation: Department of Otorhinolaryngology, Helsinki University Central Hospital, P.O. Box 220, 00029, HUS, Helsinki, Finland. Electronic address: anne.pitkaranta@hus.fi.
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics*; D006801:Humans; D008297:Male; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000191:economics / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Children; Cost-effectiveness; Health-related quality of life; Tonsillectomy