Panagiotis Anagnostis1, Ioannis Pliakos2, Stavros Panidis2,3, Angeliki Chorti2, Veronika Stelmach2, Antonios Michalopoulos2, Theodosios S Papavramidis2,3. 1. Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. pan.anagnostis@gmail.com. 2. 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3. Department of Minimal Invasive Endocrine Surgery, Interbalkan Medical Center, Thessaloniki, Greece.
Abstract
PURPOSE: The increased experience of a thyroid surgeon reduces the risk of postoperative complications. However, whether it is also cost-effective is currently unknown. The aim of the present study was to compare cost-effectiveness of high-volume (HVS) with low-volume surgeons (LVS) when performing a total thyroidectomy. METHODS: This was a retrospective study, comparing the mean cost of a total thyroidectomy per patient, between HVS and LVS. This included the cost of surgical procedure and pre- and post-operative inpatient hospitalization. A threshold of 25 thyroidectomies/year was used to discriminate between HVS and LVS. RESULTS: Four-hundred and forty-one patients were classified into HVS and 342 into the LVS group. With regard to surgical complications, higher rates of temporary hypoparathyroidism and endangered airway were observed in the LVS than in the HVS group. The estimated total cost per patient was higher in the LVS compared with the HVS group [€1721 ± 396 ($1910 ± 439) versus €979 ± 68 ($1086 ± 487); p < 0.0001]. This cost remained higher when sub-analysis was performed for each surgical stage, involving either surgical procedure or pre- and post-operative inpatient hospitalization. Differences between LVS and HVS mainly involved the cost in surgical procedure (23% attributed to occupation of the operating room) and postoperative inpatient hospitalization (45% of the total thyroidectomy cost). CONCLUSION: Total thyroidectomy performed by a HVS seems to be cost-effective compared with the one conducted by LVS. This is mostly attributed to the lower rates of surgical complications, such as postoperative hypoparathyroidism and airway obstruction.
PURPOSE: The increased experience of a thyroid surgeon reduces the risk of postoperative complications. However, whether it is also cost-effective is currently unknown. The aim of the present study was to compare cost-effectiveness of high-volume (HVS) with low-volume surgeons (LVS) when performing a total thyroidectomy. METHODS: This was a retrospective study, comparing the mean cost of a total thyroidectomy per patient, between HVS and LVS. This included the cost of surgical procedure and pre- and post-operative inpatient hospitalization. A threshold of 25 thyroidectomies/year was used to discriminate between HVS and LVS. RESULTS: Four-hundred and forty-one patients were classified into HVS and 342 into the LVS group. With regard to surgical complications, higher rates of temporary hypoparathyroidism and endangered airway were observed in the LVS than in the HVS group. The estimated total cost per patient was higher in the LVS compared with the HVS group [€1721 ± 396 ($1910 ± 439) versus €979 ± 68 ($1086 ± 487); p < 0.0001]. This cost remained higher when sub-analysis was performed for each surgical stage, involving either surgical procedure or pre- and post-operative inpatient hospitalization. Differences between LVS and HVS mainly involved the cost in surgical procedure (23% attributed to occupation of the operating room) and postoperative inpatient hospitalization (45% of the total thyroidectomy cost). CONCLUSION: Total thyroidectomy performed by a HVS seems to be cost-effective compared with the one conducted by LVS. This is mostly attributed to the lower rates of surgical complications, such as postoperative hypoparathyroidism and airway obstruction.
Authors: Theodossis S Papavramidis; Konstantinos Sapalidis; Nick Michalopoulos; Konstantina Triantafillopoulou; George Gkoutzamanis; Isaak Kesisoglou; Spiros T Papavramidis Journal: Head Neck Date: 2010-06 Impact factor: 3.147
Authors: Sebastiano Filetti; Paul W Ladenson; Marco Biffoni; Maria Giuseppina D'Ambrosio; Laura Giacomelli; Stefania Lopatriello Journal: Endocrine Date: 2016-05-12 Impact factor: 3.633
Authors: Mohamed Abdelgadir Adam; Samantha Thomas; Linda Youngwirth; Terry Hyslop; Shelby D Reed; Randall P Scheri; Sanziana A Roman; Julie A Sosa Journal: Ann Surg Date: 2017-02 Impact factor: 12.969