Cost-effectiveness analysis
The effectiveness of DCT group, which did not have bleeding, blood transfusion, re-operation, and pain, was greater than or equal to the inpatient group (Table 4). For patients with less bleeding and requiring re-operation, the effectiveness of DCT group was approximately equal to or greater than that of inpatient group. Besides, the total costs in DCT group ($ 915.1) were lower than inpatient group ($ 1227.9). Therefore, DCT was more cost effective than inpatient surgery and there was no need to calculate ICER. On the other hand, there was less blood transfusion in the inpatient group, thus, effectiveness of inpatient group (0.993) was approximately equal to or greater than that of DCT group (0.987) with no significant difference between two groups. However, the mean total costs in DCT group ($ 915.1) were lower than inpatient group ($ 1227.9). Thus, the calculated ICER was $52133, indicating that per less blood transfusion in tonsillectomy by inpatient method, $52133 should be spent. Thus, because the ICER is greater than the per capita GDP, DCT was more cost effective than inpatient method. Also, according to the Pain, patients in DCT group endured less pain. Therefore, the effectiveness of DCT group (0.730) was greater than inpatient group (0.710) and due to the lower total cost in the amount of pain of DCT group ($ 915.1) compared with inpatient group ($ 1227.9), DCT was more cost effective and there was no need to calculate ICER.