{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:28:41Z","timestamp":1765960121818,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T00:00:00Z","timestamp":1607817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Tonsillectomy and adenoidectomy in children are controversial subjects with large regional variation in surgical rates, partly explained by cultural differences and lack of high\u2010quality evidence on indications for surgery. A quality of care cycle was executed on this topic in the Netherlands. The objective of this study was to estimate changes in healthcare utilisation for paediatric tonsil surgery in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Population\u2010based data on tonsillectomies and adenoidectomies in children up to age 10 were retrieved retrospectively from Dutch administrative databases between 2005 and 2018. A change point analysis was performed to detect the most pivotal change point in surgical rates. We performed univariate analyses to compare surgical patients\u2019 characteristics before and after the pivotalpoint . Impact on healthcare budget and societal costs were estimated using current prices and data from cost\u2010effectiveness analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The annual number of adenotonsillectomies reduced by 10\u00a0952 procedures (\u221239%; from 129 per 10 000 children to 87 per 10 000 children) between 2005 and 2018, and the number of adenoidectomies by 14\u00a0757 procedures (\u221249%; from 138 per 10 000 children to 78 per 10 000 children). The most pivotal change point was observed around 2012, accompanied by small changes in patient selection for surgery before and after 2012. An estimated \u20ac5.3 million per year was saved on the healthcare budget and \u20ac10.4 million per year on societal costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The quality of care cycle resulted in fewer operations, with a concomitant reduction of costs. We suggest that part of these savings be invested in new research to maintain the quality of care cycle.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13675","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T19:48:30Z","timestamp":1606765710000},"page":"347-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in healthcare utilisation for paediatric tonsillectomy and adenoidectomy in the Netherlands: a population\u2010based study"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1670-1800","authenticated-orcid":false,"given":"Juli\u00ebtte J. C. M.","family":"van Munster","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Leiden University Medical Center  Leiden the Netherlands"},{"name":"University Neurosurgical Centre Holland (UNCH) Leiden University Medical Center and The Hague Medical Center (HMC)  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-2070","authenticated-orcid":false,"given":"Amir H.","family":"Zamanipoor Najafabadi","sequence":"additional","affiliation":[{"name":"University Neurosurgical Centre Holland (UNCH) Leiden University Medical Center and The Hague Medical Center (HMC)  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-1503","authenticated-orcid":false,"given":"Janneke","family":"van \u2019t Hooft","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC Academic Medical Center  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teus A.","family":"van Barneveld","sequence":"additional","affiliation":[{"name":"Dutch Association of Medical Specialists Knowledge Institute Domus Medica  Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-9212","authenticated-orcid":false,"given":"Stefan","family":"B\u00f6hringer","sequence":"additional","affiliation":[{"name":"Biomedical Data Sciences Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorrit S.","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Hospital &amp; Health Care LOGEX  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf H.","family":"Bremmer","sequence":"additional","affiliation":[{"name":"Department of Hospital &amp; Health Care LOGEX  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7274-1447","authenticated-orcid":false,"given":"Wilco C.","family":"Peul","sequence":"additional","affiliation":[{"name":"University Neurosurgical Centre Holland (UNCH) Leiden University Medical Center and The Hague Medical Center (HMC)  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6425-0135","authenticated-orcid":false,"given":"Wilbert B.","family":"van den Hout","sequence":"additional","affiliation":[{"name":"Biomedical Data Sciences Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-1912","authenticated-orcid":false,"given":"Peter Paul G.","family":"van Benthem","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0307-7772.2004.00771.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.01.014"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.11.1083"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.047530"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198403153101102"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38210.827917.7C"},{"key":"e_1_2_11_8_1","unstructured":"Richtlijn Ziekten van adenoid en tonsillen (ZATT) Kennisinstituut van Medisch Specialisten;2007."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5154"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.109-5111"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-017-1055-3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019405"},{"key":"e_1_2_11_14_1","unstructured":"van derStegenRPJ.Description of methods for statistics by diagnoses in time by using the LMR (1981\u20132005). 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