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Seven in 8 children's tonsillectomies are unnecessary
Researchers analysed the electronic medical records of over 1.6 million children from more than 700 UK general practices dating between 2005 and 2016. They found that out of 18,271 children who had their tonsils removed during this time, only 2,144 (11.7 per cent) had enough sore throats to justify surgery.
The researchers at the University's Institute of Applied Health Research concluded that their evidence, published today (Nov 6th) in British Journal of General Practice, showed that annually 32,500 children undergo needless tonsillectomies at a cost to the NHS of £36.9 million.
What's more, they found that many children who might benefit from having their tonsils removed are not having the surgical procedure. They found that of 15,764 children who had records showing sufficient sore throats to undergo a tonsillectomy, just 2,144 (13.6 per cent) actually went on to have one.
[...] Tom Marshall, Professor or Public Health and Primary Care at the University of Birmingham, said: "Research shows that children with frequent sore throats usually suffer fewer sore throats over the next year or two. In those children with enough documented sore throats, the improvement is slightly quicker after tonsillectomy, which means surgery is justified.
"But research suggests children with fewer sore throats don't benefit enough to justify surgery, because the sore throats tend to go away anyway.
"Our research showed that most children who had their tonsils removed weren't severely enough affected to justify treatment, while on the other hand, most children who were severely enough affected with frequent sore throats did not have their tonsils removed. The pattern changed little over the 12 year period.
"Children may be more harmed than helped by a tonsillectomy. We found that even among severely affected children only a tiny minority of ever have their tonsils out. It makes you wonder if tonsillectomy ever really essential in any child."
Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records (DOI 10.3399/bjgp18X699833$)
(Score: 0) by Anonymous Coward on Wednesday November 07 2018, @07:27PM (2 children)
It's silly, because you have to account for resources; you can't move away from a fee-for-service system.
Secondly, it's wrong, because all of these problems are caused by the very attempt to move away from a fee-for-service system. The UK has its NHS, where people don't have to think all that much about fees for services; they just do what the officials say to do, and money changes hands... somehow.
The same problem occurs in the United States, where "insurance" companies have nothing to do with mitigating risk, and have been transformed over almost a century into specialized payment networks; nobody knows what anything costs, and they just do whatever the white coats say, with money changing hands and being negotiated by third parties.
And, ironically, here you are telling us that we need even more of this insane non-accounting system.
(Score: 2) by Immerman on Wednesday November 07 2018, @08:41PM (1 child)
>you can't move away from a fee-for-service system.
The fact that the Chinese medical system was traditionally NOT fee-for-service says otherwise. You paid your doctor when you were healthy, and stopped paying him when you were ill. Gave him a direct economic incentive to practice preventative medicine, and get you healthy again as soon as possible, and as cheaply.
Such a system would likely not scale directly to modern size and specialization, but it provides solid evidence that their are functional alternatives, the challenge is in developing them for modern realities.
(Score: 0) by Anonymous Coward on Wednesday November 07 2018, @08:45PM
Those people were paying for services that would keep them healthy, such as the production of herbal teas.
Naturally, when you get sick despite drinking herbal teas, you take your business elsewhere.