title: Pediatric Patient and Hospital Characteristics Associated With Treatment of Peritonsillar Abscess and Peritonsillar Cellulitis.
abstract: OBJECTIVE
  To identify patient and hospital characteristics associated with the choice of treatment for pediatric patients who present in the acute setting with peritonsillar abscess/cellulitis (PTA/PTC).
  
  
  METHODS
  A retrospective cohort study was performed using Healthcare Cost and Utilization Project emergency department, ambulatory, and inpatient state databases for the years 2010 and 2011. Children aged 0 to 17 years were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code for PTA/PTC. The main outcome of interest was treatment received, which included medical therapy alone, incision and drainage (IND) or tonsillectomy. Multiple logistic regression analyses were conducted to model non-clinical factors associated with treatment received after adjusting for age, hospital state, race, primary expected payer, existing chronic condition(s), and type of hospital.
  
  
  RESULTS
  We identified 2994 patients who presented with PTA/PTC. The most common treatment choice was medical therapy alone (30.8%), followed by IND (30.5%) and tonsillectomy (9.4%). There were significant associations between treatment choice and race, primary payer status, and type of hospital (P < .05). We found that Hispanic patients, those with Medicaid as their primary expected payer, and those treated at a designated children's hospital were 3 nonclinical factors independently associated with an increase in likelihood of receiving tonsillectomy as treatment.
  
  
  CONCLUSIONS
  There are important nonclinical factors associated with treatment of children who present in the acute setting with PTA/PTC. Additional research is recommended to understand these observed differences in care and how they may affect health outcomes.
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Thuy
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Corinna Anke
authors.initials: CA
authors.lastname: Haberland
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA, USA boussard@stanford.edu.
authors.forename: Tina
authors.initials: T
authors.lastname: Hernandez-Boussard
mesh_terms: D000293:Adolescent; D002481:Cellulitis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D000039:Peritonsillar Abscess / Q000628:therapy; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000706:statistics & numerical data; D014069:Tonsillitis / Q000628:therapy*; D014481:United States
keywords: peritonsillar abscess/peritonsillar cellulitis (PTA/PTC); tonsillectomy