• Udayan K Shah, Zachary Theroux, Gopi B Shah, William J Parkes, and Christine Schuck.
• Department of Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, U.S.A.; Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A; Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
• Laryngoscope. 2014 May 1;124(5):1223-8.

Objectives/HypothesisTo analyze variables that affect time and cost parameters of pediatric adenotonsillectomy.Study DesignLongitudinal 7-month retrospective review of sequential tonsil and adenoid surgery at a university pediatric tertiary care hospital.MethodsAll children aged 2 to 12 years who underwent adenotonsillectomy from May 2008 to October 2008 had charts and billing records analyzed for variations in charges and times of adenotonsillectomy according to patient age, body mass index for age (BMIFA), American Society of Anesthesiologists (ASA) status, surgical indication, technology used, and teaching status of case. A total of 214 children had records reviewed.ResultsStatistically significant variations were observed for all measured parameters except for indications for surgery. Children 3 years and younger had shorter procedures (P = .005) and total operating room times (P = .037). Charges for supplies were lower for ASA 1 patients than for ASA 2 patients (P = .010). Obese children with elevated BMIFA required longer procedures (P = .039) and more expensive surgery (P = .003). Procedure times were shorter for Coblation (ArthroCare, Austin, TX) compared with electrocautery (P = .27) and for microdebrider compared with electrocautery (P < .001). Charges for Coblation were substantially higher (P < .001). Teaching cases took longer (P < .001).ConclusionsCharges and times for adenotonsillectomy surgery varied by patient age, BMIFA, ASA status, tonsillectomy technique, and teaching case status. Clinically salient differences were noted for ASA status, BMIFA, and surgical technique. This method of cost analysis provides useful information for resource management in tonsillectomy.© 2013 The American Laryngological, Rhinological and Otological Society, Inc.

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