{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:39:04Z","timestamp":1747183144493,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe obstructive sleep apnoea (OSA) is associated with increased risk of respiratory compromise in the post\u2010operative period following adenotonsillectomy (AT). This study analyses the economic cost of polysomnography or overnight oximetry as part of pre\u2010operative risk stratification in paediatric AT, supplementing previously published research demonstrating the efficacy of this protocol in predicting respiratory complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cost\u2010minimisation analysis examines costs associated with pre\u2010operative overnight oximetry and polysomnography in triaging paediatric patients older than 2\u2009years old, with no major comorbidities except for OSA, undergoing AT for OSA (<jats:italic>n<\/jats:italic>\u00a0=\u00a01801) to either a secondary or quaternary Australian hospital. Decision analysis modelling via probability trees were utilized to estimate pre\u2010 and peri\u2010operative costs. A third hypothetical \u2018no investigation\u2019 model based upon conducting all AT at a secondary hospital was performed. Costs are derived from the financial year 2020\u20132021, censored at discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total cost per patient of AT including pre\u2010operative investigations of oximetry and polysomnography, and associated inpatient costs, were AUD4181.34 and 5013.99 respectively. This is more expensive compared to a hypothetical no\u2010investigation model (AUD3958.98).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Within the scope of this partial economic evaluation, this study finds a small additional cost for a model of care involving overnight oximetry as a pre\u2010operative triage tool, balanced by the reduced cost of care in a lower acuity centre for low\u2010risk patients and potential high cost of complications if all children are treated in a low acuity centre. This supports oximetry in peri\u2010operative risk stratification for paediatric AT from a financial perspective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17858","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T07:46:06Z","timestamp":1655711166000},"page":"2292-2298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cost\u2010minimisation analysis of polysomnography and pulse oximetry in a risk stratification protocol for paediatric adenotonsillectomy"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-5986","authenticated-orcid":false,"given":"Seraphina","family":"Key","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7253-3119","authenticated-orcid":false,"given":"Clemente","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health Melbourne Victoria Australia"},{"name":"Department of Head and Neck Surgical Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Nixon","sequence":"additional","affiliation":[{"name":"Melbourne Children's Sleep Centre Monash Health, Monash Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Paediatrics Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Paddle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health Melbourne Victoria Australia"},{"name":"Department of Surgery, Faculty Medicine, Nursing &amp; Health Sciences Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"511","volume-title":"Thorax","author":"Nixon GM","year":"2005"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(87)90088-7"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.93.5.784"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1992.01880090056017"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.1.e19"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000244318.77377.67"},{"key":"e_1_2_13_8_1","first-page":"151","volume-title":"The Uses of Overnight Pulse Oximetry [Internet]","author":"Singh S","year":"2020"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14586"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.2.405"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/ajo-19-75"},{"first-page":"9","volume-title":"Australian Institute of Health and Welfare. Elective Surgery Waiting Times [Internet]","year":"2015","key":"e_1_2_13_12_1"},{"key":"e_1_2_13_13_1","unstructured":"Australian Institute of Health and Welfare.Admitted patient care: 2017\u201018 [Internet]. Australian Hospital Statistics 2009\u201010. Canberra 2019. [Cited 14 Mar 2021.] Available from URL:www.aihw.gov.au."},{"key":"e_1_2_13_14_1","unstructured":"Australian Institute of Health and Welfare.Australia's health 2020 data insights. Australia's health series no. 17. Cat. no. AUS 231. [Internet]. Canberra 2020. [Cited 14 Mar 2021.] Available from URL:https:\/\/www.aihw.gov.au\/getmedia\/be95235d-fd4d-4824-9ade-34b7491dd66f\/aihw-aus-231.pdf.aspx?inline=true"},{"key":"e_1_2_13_15_1","unstructured":"Independent hospital pricing authority.NWAU calculators 2020\u201021 | admitted acute [internet]. Darlinghurst 2019. [Cited 14 Mar 2021.] Available from URL:https:\/\/www.ihpa.gov.au\/what-we-do\/pricing\/national-weighted-activity-unit-nwau-calculators\/nwau-calculators-2020-21"},{"volume-title":"National Efficient Price Determination 2020\u201321 [Internet]","year":"2020","author":"Independent Hospital Pricing Authority","key":"e_1_2_13_16_1"},{"key":"e_1_2_13_17_1","unstructured":"Department of Health and Human Services.Activity Based Funding [Internet]. Victoria State Government p. 1\u201317 2018. [Cited 14 Mar 2021.] Available from URL:https:\/\/www2.health.vic.gov.au\/hospitals-and-health-services\/funding-performance-accountability\/activity-based-funding"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.584"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X9301300409"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1049"},{"key":"e_1_2_13_21_1","unstructured":"AASM Scoring Manual\u2010American Academy of Sleep Medicine [Internet].American Academy of Sleep Medicine 2020. [Cited 14 Mar 2021.] Available from URL:https:\/\/aasm.org\/clinical-resources\/scoring-manual\/"},{"key":"e_1_2_13_22_1","unstructured":"Australian Government Department of Health.Medicare benefits schedule\u2010item 12210 [internet]. Online 2013[Cited 14 Mar 2021.] Available from URL:http:\/\/www9.health.gov.au\/mbs\/fullDisplay.cfm?type=item&qt=ItemID&q=12210"},{"key":"e_1_2_13_23_1","unstructured":"Department of Health and Human Services.Ambulance Victoria fee schedule 2020\u201021 [Internet]. Victoria State Government 2020. [Cited 14 Mar 2021.] Available from URL:https:\/\/www2.health.vic.gov.au\/hospitals-and-health-services\/patient-care\/ambulance-and-nept\/ambulance-fees"},{"key":"e_1_2_13_24_1","unstructured":"Center for the Evaluation of Value and Risk in Health.CEA registry [internet]. Tufts Medical Center.2020. [Cited 14 Mar 2021.] Available from URL:https:\/\/cevr.tuftsmedicalcenter.org\/databases\/cea-registry"},{"key":"e_1_2_13_25_1","first-page":"1","article-title":"North of England and Scotland study of tonsillectomy and adeno\u2010tonsillectomy in children (NESSTAC): a pragmatic randomised controlled trial with a parallel nonrandomised preference study","volume":"14","author":"Lock C","year":"2010","journal-title":"Health Technol Assess (Rockv) [Internet]"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818760513"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21128"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-018-0396-4"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24025"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200006000-00004"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2127"},{"key":"e_1_2_13_32_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/oso\/9780198529446.003.0003","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond MF","year":"2005"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1812"},{"key":"e_1_2_13_34_1","unstructured":"Pound Sterling Live.Convert U.S. Dollars into Australian Dollars: History 2017 [Internet].2020. [Cited 14 Mar 2021.] Available from URL:https:\/\/www.poundsterlinglive.com\/best-exchange-rates\/best-us-dollar-to-australian-dollar-history-2017"},{"key":"e_1_2_13_35_1","unstructured":"Independent Hospital Pricing Authority.National Efficient Price Determination 2017\u201018 [Internet].2017. [Cited 14 Mar 2021.] Available from URL:http:\/\/www.ihpa.gov.au\/internet\/ihpa\/publishing.nsf\/Content\/CA25794400122452CA257C8400185FBC\/$File\/NationalEfficient Price Determination2014\u201015.pdf"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.778"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110313"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312120922027"},{"key":"e_1_2_13_39_1","unstructured":"Australian Commission on Safety and Quality in Healthcare.Australian Atlas of Healthcare Variation 2015: Chapter 3.6 Chapter 3.6\u2010Tonsillectomy hospital admissions 17\u2009years and under [Internet]. Canberra 2015. [Cited 14 Mar 2021.] Available from URL:https:\/\/www.safetyandquality.gov.au\/sites\/default\/files\/migrated\/SAQ201_04_Chapter3_v6_FILM_tagged_merged_3-6.pdf"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.3431"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17858","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.17858","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.17858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T12:00:15Z","timestamp":1700740815000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.17858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,20]]},"references-count":39,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1111\/ans.17858"],"URL":"https:\/\/doi.org\/10.1111\/ans.17858","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"type":"print","value":"1445-1433"},{"type":"electronic","value":"1445-2197"}],"subject":[],"published":{"date-parts":[[2022,6,20]]},"assertion":[{"value":"2022-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}