Comparison of Healthcare Utilization After Intracapsular and Extracapsular Tonsillectomy.

Abstract

The objective of this study was to analyze differences in postoperative healthcare utilization between intracapsular tonsillectomy (ICT) and traditional extracapsular tonsillectomy (ECT). Identifying approaches that reduce postoperative healthcare utilization may help optimize resource use and improve value-based care delivery. This was a retrospective cohort study of patients who underwent either ICT or ECT at a tertiary care children's hospital between 2019 and 2024. The chart was reviewed for demographics, pain medication administration, unplanned nursing phone calls, emergency department visits, and readmissions. Comparisons between groups were performed using logistic regressions, adjusted for age at surgery and pain prescription protocol. A total of 11,205 subjects were included, 1705 (15%) of which had ICT. There were no demographic differences between the ICT and ECT cohorts. The ICT cohort had lower proportions of unplanned phone calls (5.3% vs. 10.5%, p < 0.001), 15-day all-cause ED returns (7.9% vs. 11.9%, p < 0.001), and hospital readmissions (1.2% vs. 2.7%, p < 0.001). The drivers of healthcare utilization were oral bleeding and pain-related complaints, including decreased oral intake. ICT, compared to ECT results in fewer postoperative unplanned healthcare contacts, which translates to improved resource allocation for hospitals and a lower financial load for families. Quicker return to work and school also decreases the economic burden on society. These findings can inform surgical decision-making discussions and contribute to future cost-benefit analyses.