To develop a simple method for assessing the proportion of children referred to hospital for tonsillectomy in different areas likely to be suitable for day case treatment based on their medical and social characteristics.
Four patients suitability criteria were selected based on previous experience of successful day case surgery and a literature review of the prevalence of contraindications and postoperative complications, as follows :
medical contraindications (at least American Society of Anesthetists grade ASA2 to be eligible) ;
home circumstances (no telephone, no car and single parent households were ineligible) ;
distance from the hospital (more than 10 miles resulted in ineligibility) ;
and likelihood of postoperative complications.
Data relating to the social criteria were collected prospectively from 500 children under 12 years of age reviewed in the outpatient department and under the care of one of the authors.
In addition, the electoral ward UPA8 (Jarman 8) deprivation score relevant to each child was recorded and the sample was divided into quintiles according to mean UPA8 scores.
In each quintile, the percentage of children with the appropriate social criteria for day case tonsillectomy was calculed.
The relationship between deprivation score and social criteria for day case tonsillectomy was determined using logistic regression. (...)
Mots-clés Pascal : Environnement social, Amygdalectomie, Chirurgie, Intervention, Traitement, Enfant, Logement habitation, Ambulatoire, Politique, Soin, Politique sanitaire
Mots-clés Pascal anglais : Social environment, Tonsillectomy, Surgery, Operation, Treatment, Child, Housing, Ambulatory, Policy, Care, Health policy
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 06/10/1999.