Karole Collier1, John Sataloff2, Chris Wirtalla2, Lindsay Kuo2, Giorgos C Karakousis2, Rachel R Kelz2. 1. Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA. Electronic address: collier.karole@gmail.com. 2. Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA.
Abstract
BACKGROUND: In anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions. METHODS: Patients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Primary outcome was readmission within 90 days. Univariate and multivariable logistic regression were used to determine factors associated with readmission. Subset analysis was performed for thyroid cancer patients. RESULTS: Among 59,427 patients, 34.2% had thyroid cancer. Eleven percent (n = 6462) were readmitted within 90 days, with 27% readmitted to a different hospital than the index. 66.2% of thyroid cancer patients were readmitted for a related condition. CONCLUSION: Eleven percent of patients are admitted to the hospital within 90 days of an operation in the thyroid or parathyroid glands. Patient factors and diseases necessitate the use of hospital services. Bundled payments must consider the patients' needs for hospital-based services in calculating costs for surgically treated endocrine disorders.
BACKGROUND: In anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions. METHODS:Patients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Primary outcome was readmission within 90 days. Univariate and multivariable logistic regression were used to determine factors associated with readmission. Subset analysis was performed for thyroid cancerpatients. RESULTS: Among 59,427 patients, 34.2% had thyroid cancer. Eleven percent (n = 6462) were readmitted within 90 days, with 27% readmitted to a different hospital than the index. 66.2% of thyroid cancerpatients were readmitted for a related condition. CONCLUSION: Eleven percent of patients are admitted to the hospital within 90 days of an operation in the thyroid or parathyroid glands. Patient factors and diseases necessitate the use of hospital services. Bundled payments must consider the patients' needs for hospital-based services in calculating costs for surgically treated endocrine disorders.
Authors: Alan Zambeli-Ljepović; Frances Wang; Michaela A Dinan; Terry Hyslop; Michael T Stang; Sanziana A Roman; Julie A Sosa; Randall P Scheri Journal: Surgery Date: 2019-07-06 Impact factor: 3.982
Authors: Asmae Toumi; Catherine DiGennaro; Vahab Vahdat; Mohammad S Jalali; G Scott Gazelle; Jagpreet Chhatwal; Rachel R Kelz; Carrie C Lubitz Journal: Thyroid Date: 2021-01-18 Impact factor: 6.506