Comparison of inpatient and outpatient thyroidectomy: Demographic and economic disparities
Comparison of inpatient and outpatient thyroidectomy: Demographic and economic disparities
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DOI：
10.1016/j.ejso.2016.03.010
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发表时间：
2016-07-01
期刊：
影响因子：
3.8
通讯作者：
Kandil, E.
中科院分区：
文献类型：
--
作者：
Al-Qurayshi, Z.;Srivastav, S.;Kandil, E.
背景：甲状腺切除术越来越多地被用作门诊手术。在这项研究中，我们的目的是检查患者的特点和临床因素与门诊甲状腺手术相比，住院手术。方法：2007-2010年进行横断面研究。住院患者和门诊患者分别从全国住院患者样本和国家门诊手术和服务数据库中选择。所有患者均为在佛罗里达州和纽约州接受甲状腺切除术的成年人（>= 18岁）。结果：共纳入门诊25267例，住院8219例。门诊患者多为女性、白人、有私人保险、有一种或无合并症（p < 0.001）。非恶性甲状腺疾病的甲状腺手术在门诊更常见（p < 0.05）。大容量外科医生更有可能进行门诊甲状腺切除术（p < 0.001）。门诊后甲状腺切除术并发症在小体积手术中较高（p < 0.001）。此外，与大容量外科医生相比，小容量外科医生进行门诊手术的医院费用显著更高（p < 0.001）。结论：门诊甲状腺切除术的应用存在种族和经济差异。经验丰富的外科医生更有可能提供门诊甲状腺切除术，并且由他们进行的手术具有更有利的结果和更低的住院费用。(C) 2016 Elsevier Ltd.版权所有。
Background: Thyroidectomy is increasingly being performed as an outpatient procedure. In this study, we aim to examine patient characteristics and clinical factors associated with outpatient thyroid surgeries as compared to inpatient procedures.Methods: A cross-sectional study for the period of 2007-2010. Inpatients and outpatients were selected from the Nationwide Inpatient Sample and State Ambulatory Surgery and Services Databases, respectively. All patients were adults (>= 18 years) who underwent thyroidectomy in the States of Florida and New York.Results: A total of 25,267 outpatients, and 8219 inpatients were included. Outpatients were more likely to be female, White, have private insurance, and have one or no comorbidities (p < 0.001 each). Thyroid surgeries performed for thyroid conditions other than malignancy were more common in the outpatient settings (p < 0.05 each). High-volume surgeons were more likely to perform ambulatory thyroidectomy (p < 0.001). Post-outpatient thyroidectomy complications were higher for lower volume surgeons (p < 0.001). Moreover, hospital charges for outpatient surgeries performed by lower volume surgeons were significantly higher compared to high-volume surgeons (p < 0.001).Conclusions: Racial and economic disparities exist in the utilization of ambulatory thyroidectomy. Experienced surgeons are more likely to provide ambulatory thyroidectomy, and surgeries performed by them are associated with more favorable outcomes and lower hospital charges. (C) 2016 Elsevier Ltd. All rights reserved.