National Trends and Factors Associated with Hospital Costs Following Thyroid Surgery

Biron, Vincent L.; Bang, Heejung; Farwell, D. Gregory; Bewley, Arnaud F.

doi:10.1089/thy.2014.0495

Cited by 18 publications

(12 citation statements)

References 18 publications

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“…The NIS was not developed as a research tool, but it provides valuable information on rare diseases at a national level. Nevertheless, the NIS database has been previously used for landmark studies in the thyroid field (13)(14)(15)(16). Using ICD-9 codes always carries a risk of misclassifications.…”

Section: Discussionmentioning

confidence: 99%

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Galindo

Hurtado

Pasquel

et al. 2019

Thyroid

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Background: Current evidence on the incidence and outcomes of patients with thyroid storm in the United States is limited to single-center case series. This study determined the national incidence of thyrotoxicosis with and without thyroid storm and clinical outcomes among hospitalized patients during a 10-year period in the United States. Methods: Retrospective longitudinal analysis was conducted of clinical characteristics, mortality, hospital length of stay, and costs from 2004 to 2013. Adults (‡18 years of age) with a primary diagnosis of thyrotoxicosis with and without thyroid storm were included. To determine the incidence, outcomes, and cost of thyrotoxicosis with and without thyroid storm, the study used data from the National Inpatient Sample database, the largest public inpatient database, with a representative sample of all non-federal hospitals in the United States. Results: Among 121,384 discharges with thyrotoxicosis during the study period (M agestandard error = 48.7-0.11 years; 51.9% Caucasian; 77.3% female), 19,723 (16.2%) were diagnosed with thyroid storm. During the past decade, the incidence of thyroid storm ranged between 0.57 and 0.76 cases/100,000 U.S. persons per year, and 4.8 and 5.6/ 100,000 hospitalized patients per year. Thyroid storm was associated with significantly higher hospital mortality (1.2-3.6% vs. 0.1-0.4%, p < 0.01) and longer length of stay (4.8-5.6 vs. 2.7-3.4 mean days, p < 0.001) compared to patients with thyrotoxicosis without storm. Inflation-adjusted hospitalization costs progressively increased in patients with thyroid storm from $9942 to $12,660 between 2004 and 2013 (p < 0.01). Conclusions: One of every six discharges for thyrotoxicosis was diagnosed with thyroid storm. Thyroid storm is associated with a 12-fold higher mortality rate compared to thyrotoxicosis without storm. The incidence and mortality of thyroid storm has not substantially changed in the past decade. However, hospitalization costs have significantly increased.

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Section: Discussionmentioning

confidence: 99%

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Galindo

Hurtado

Pasquel

et al. 2019

Thyroid

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“…According to 2 National Inpatient Sample (NIS) database studies, low-volume surgeons were more likely to operate in rural locations 76 and have a higher rate of complications, 76 and costs were higher after thyroidectomy at a rural center. 77 White et al 78 published that rural patients who traveled to academic centers for treatment of papillary thyroid carcinoma (PTC) were more likely to receive standard-of-care treatment, although they were unable to detect a difference in overall survival. Richmond et al 79 refuted thyroidectomies performed at high-volume and academic centers had lower complication rates by publishing a retrospective cohort from their solo rural practice.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies assessed thyroidectomy and parathyroidectomy in a rural setting. According to 2 National Inpatient Sample (NIS) database studies, low‐volume surgeons were more likely to operate in rural locations 76 and have a higher rate of complications, 76 and costs were higher after thyroidectomy at a rural center 77 . White et al 78 published that rural patients who traveled to academic centers for treatment of papillary thyroid carcinoma (PTC) were more likely to receive standard‐of‐care treatment, although they were unable to detect a difference in overall survival.…”

Section: Resultsmentioning

confidence: 99%

Rural Otolaryngology Care Disparities: A Scoping Review

Urban

Shimomura

Shah

et al. 2022

Otolaryngol.--head neck surg.

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Objective To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work. Study Design Scoping review. Data Sources A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL. Review Methods The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed, English-language, US-based studies examining a rural disparity in otolaryngology-related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded. Results The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy-five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design. Conclusion Overall, there was low-quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.

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“…Naturally, these devices may have advantages to offer in some cases, possibly reducing morbidity or the time of surgery, but always at a cost. The technology adds to the total costs associated with thyroid surgery, as was demonstrated using the Nationwide Inpatient Sample (NIS) database [ 55 ] and Premier Healthcare Database [ 43 ]. However, often the enthusiasm for new technology has meant that a rigorous cost-effectiveness/value analysis is not performed until the devices have become ingrained in surgical practice.…”

Section: Surgical Technology: a Cost-effective Addition?mentioning

confidence: 99%

Differentiated Thyroid Cancer: A Health Economic Review

Heede

Tolley

Marco

et al. 2021

Cancers

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The incidence of differentiated thyroid cancer (DTC) is rising, mainly because of an increased detection of asymptomatic thyroid nodularity revealed by the liberal use of thyroid ultrasound. This review aims to reflect on the health economic considerations associated with the increasing diagnosis and treatment of DTC. Overdiagnosis and the resulting overtreatment have led to more surgical procedures, increasing health care and patients’ costs, and a large pool of community-dwelling thyroid cancer follow-up patients. Additionally, the cost of thyroid surgery seems to increase year on year even when inflation is taken into account. The increased healthcare costs and spending have placed significant pressure to identify potential factors associated with these increased costs. Some truly ground-breaking work in health economics has been undertaken, but more cost-effectiveness studies and micro-cost analyses are required to evaluate expenses and guide future solutions.

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National Trends and Factors Associated with Hospital Costs Following Thyroid Surgery

Cited by 18 publications

References 18 publications

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Rural Otolaryngology Care Disparities: A Scoping Review

Differentiated Thyroid Cancer: A Health Economic Review

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