title: Indirect costs related to caregivers' absence from work after paediatric tonsil surgery.
abstract: Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers' absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1-11 were included, n = 4534. The number of days the child needed analgesics after surgery was used as a proxy to estimate the number of work days lost for the caregiver. Data from the Social Insurance Agency (Försäkringskassan) regarding the days the parents received temporary parental benefits in the month following surgery were also analysed. The indirect costs due to the caregivers' absenteeism after tonsillectomy vs tonsillotomy were calculated, using the human capital method. The patient-reported use of postoperative analgesic use was 77% (n = 3510). Data from the Social Insurance Agency were gathered for all 4534 children. The mean duration of analgesic treatment was 4.6 days (indirect cost of EUR 747). The mean number of days with parental benefits was 2.9 (EUR 667). The indirect cost of tonsillectomy was 61% higher than that of tonsillotomy (EUR 1010 vs EUR 629). The results show that the choice of surgical method affects the indirect costs, favouring the use of tonsillotomy over tonsillectomy for the treatment of children with SDB, due to less postoperative pain.
authors.affiliation: Department of Otorhinolaryngology, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gröna stråket 9, 413 46, Gothenburg, Sweden. gunhildur.gudnadottir@vgregion.se.
authors.forename: Gunnhildur
authors.identifier: http://orcid.org/0000-0001-5904-2043
authors.initials: G
authors.lastname: Gudnadottir
authors.affiliation: The Swedish Institute for Health Economics (IHE), Lund, Sweden.
authors.forename: G Ragnarson
authors.initials: GR
authors.lastname: Tennvall
authors.affiliation: Department of Otorhinolaryngology, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gröna stråket 9, 413 46, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Stalfors
authors.affiliation: Department of Otorhinolaryngology, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gröna stråket 9, 413 46, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Hellgren
mesh_terms: D000041:Absenteeism; D000700:Analgesics / Q000627:therapeutic use; D017028:Caregivers / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012891:Sleep Apnea Syndromes / Q000191:economics / Q000209:etiology / Q000601:surgery; D013548:Sweden; D014068:Tonsillectomy / Q000191:economics* / Q000379:methods
chemical_list: D000700:Analgesics
keywords: Absenteeism; Health economy; Indirect cost; Tonsillectomy; Tonsillotomy