Assessing the Quality of the Management of Tonsillitis among Australian Children: A Population-Based Sample Survey

Peter Hibbert, Jacqueline H. Stephens, Carl de Wet, Helena Williams, Andrew Hallahan, Gavin R. Wheaton, Chris Dalton, Hsuen P. Ting, Gaston Arnolda, Jeffrey Braithwaite

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objective: The aims of this study were twofold: (1) to design and validate a set of clinical indicators of appropriate care for tonsillitis and (2) to measure the level of tonsillitis care that is in line with guideline recommendations in a sample of Australian children. Study Design: A set of tonsillitis care indicators was developed from available national and international guidelines and validated in 4 stages. This research used the same design as the CareTrack Kids study, which was described in detail elsewhere. Setting: Samples of patient records from general practices, emergency departments, and hospital admissions were assessed. Subjects and Methods: Patient records of children aged 0 to 15 years were assessed for the presence of, and adherence to, the indicators for care delivered in 2012 and 2013. Results: Eleven indicators were developed. The records of 821 children (mean age, 5.0 years; SD, 4.0) with tonsillitis were screened. The reviewers conducted 2354 eligible indicator assessments across 1127 visits. Adherence to 6 indicators could be assessed and ranged from 14.3% to 73.2% (interquartile range 31.5% to 72.2%). Conclusion: Our main findings are consistent with the international literature: the treatment of many children who present with confirmed or suspected tonsillitis is inconsistent with current guidelines. Future research should consider how the indicators could be applied in a structured and automated manner to increase the reliability and efficiency of record reviews and help raise clinicians’ awareness of appropriate tonsillitis management.

Original languageEnglish
Pages (from-to)137-144
Number of pages8
JournalOtolaryngology-Head and Neck Surgery
Issue number1
Publication statusPublished - Jan 2019


  • child health
  • guideline adherence
  • health care quality indicators
  • patient safety
  • tonsillitis


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