Introduction

Paediatric tonsillectomy is a commonly performed surgical procedure. In Australia in 2017-18, paediatric tonsillectomy accounted for 750 hospitalisations per 100 000.(1) The main indications include sleep disordered breathing (SDB) and recurrent tonsillitis (RT).(2, 3) These conditions adversely impact the child’s quality of life (QoL) and behaviour. Furthermore, there are consequential effects on the child’s parents and the health system, such as days off school translating to days off work for their parents, and an increase in presentations at primary care clinics and emergency rooms.(4-6)
Australia has a mixed public and private healthcare system where the former is entirely government-funded whereas the latter is government-subsidised with the remainder paid by the patient and their private health insurer. In 2017-18, the median waiting time for tonsillectomy (after initial specialist consultation) in an Australian public hospital was 121 days.(7) Private hospitals in Australia perform 50% more tonsillectomies than public hospitals, yet public patients wait almost 3 times longer.(8, 9) This highlights an inequality in healthcare access where there are higher rates of tonsillectomies in patients of higher socioeconomic status despite higher rates of SDB and RT in patients of a lower socioeconomic status.(10)
This study aimed to evaluate changes in QoL of paediatric patients while awaiting tonsillectomy in an Australian public hospital, following recovery from surgery, and long term.