Economic Viability and Efficacy of Day Case Versus Inpatient Tonsillectomy in Southern Iran

Objectives: Day case tonsillectomy compared with inpatient tonsillectomy has increasingly become a trend for many patients undergoing elective surgeries. Unjustified stays of tonsillectomy can be avoided by day case surgery, which consequently reduces treatment costs. The aim of this study was therefore to determine the cost and effectiveness of day case tonsillectomy compared with inpatient tonsillectomy. Methods: This cost-effectiveness study was performed on 300 patients from May 2017 to April 2018. Patients were randomly divided into 2 groups: day case (n = 150) and inpatient (n = 150). Consequences used in model included incidence of bleeding, blood transfusion, and reoperation frequency within 2 weeks after surgery and also the patients' pain during 24 hours after surgery. Costs were collected from societal perspective, so the costs included direct medical and nonmedical costs as well as indirect costs. One-way sensitivity analysis was conducted to measure the uncertainty effects of the parameters. The collected data were analyzed using software TreeAge and Excel 2016. Results: Day case tonsillectomy was more cost-effective than inpatient. Mean total costs in day case and inpatient were $915.1 and $1227.9, respectively. Besides, the mean effectiveness was 0.921 and 0.914 percent, respectively. Also, 1-way sensitivity analysis proved the robustness of the results of study. Conclusions: Day case tonsillectomy is a cost-effective strategy and can be suggested as a good alternative for a wide range of patients after tonsillectomy. Supporting day case surgery for tonsillectomy cases can significantly reduce the financial burden.