Rising Cost of Thyroid Surgery in Adult Patients.
Rising Cost of Thyroid Surgery in Adult Patients.
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DOI：
10.1016/j.jss.2020.11.049
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Mathur A
中科院分区：
文献类型：
--
作者：
Sahli ZT;Zhou S;Sharma AK;Segev DL;Massie A;Zeiger MA;Mathur A
本研究的目的是描述接受选择性甲状腺切除术的成年人的经济趋势。我们利用 Premier Healthcare 数据库进行了一项基于人群的研究，以检查 2006 年 1 月至 2014 年 12 月期间接受选择性甲状腺切除术的成年患者。时间分为三个相等的时间段（2006-2008 年、2009-2011 年、2012-2014 年）。为了检查患者费用的趋势，我们使用广义线性回归对患者费用进行建模，该回归调整关键协变量以及聚集在医院级别的标准误差。我们的研究队列由 52,012 名接受甲状腺手术的成年患者组成。在研究期间，最常见的手术从甲状腺叶切除术变为双侧甲状腺切除术。在研究期间，完成甲状腺切除术的比例从 1.1% 增加到 1.6% (p <0.001)，恶性诊断从 21.7% 增加到 26.8% (p <0.001)，在教学医院进行的手术从 27.7% 增加到 32.9% (p <0.001)，门诊手术从 93.85% 增加到97.55%（p <0.001）。预测前根据通货膨胀调整后的中位患者费用每年增加 895 美元，即 4.3%，9 年来增加了 38.8%。甲状腺切除术费用较高与男性患者、恶性手术病理、接受有限或根治性颈清扫术的患者、出现并发症、拥有管理医疗保险的患者以及住院时间较长有关。尽管最近甲状腺手术的做法发生了变化，以减轻医院的经济负担，但费用仍以每年 4.3% 的速度增长。需要进行更多的前瞻性研究来确定与成本增加相关的因素。
The aim of this study is to describe the economic trends in adults who underwent elective thyroidectomy. We performed a population-based study utilizing the Premier Healthcare Database to examine adult patients who underwent elective thyroidectomy between January 2006 and December 2014. Time was divided into three equal time periods (2006–2008, 2009–2011, 2012–2014). To examine trend in patient charges, we modelled patient charges using generalized linear regressions adjusting for key covariates with standard errors clustered at the hospital level. Our study cohort consisted of 52,012 adult patients who underwent a thyroid operation. During the study period, the most common procedure changed from a thyroid lobectomy to bilateral thyroidectomy. Over the study period, there was an increase in the proportion of completion thyroidectomies from 1.1% to 1.6% (p <0.001), malignant diagnoses from 21.7% to 26.8% (p <0.001), procedures performed at teaching hospitals from 27.7% to 32.9% (p <0.001), and procedures performed on an outpatient basis from 93.85% to 97.55% (p <0.001). Pre-proThe annualincreaseinmedianpatientcharge adjusted for inflation was $895 or 4.3% resulting in an increase of 38.8% over 9 years. Higher thyroidectomy charges were associated with male patients, malignant surgical pathology, patients undergoing limited or radical neck dissection, experiencing complications, those with managed healthcare insurance, and a prolonged length of stay. Despite recent changes in thyroid surgery practices to decrease the economic burden of hospitals, costs continue to rise 4.3% annually. Additional prospective studies are needed to identify factors associated with this increasing cost.
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影响因子：
3.4
作者：
Marino, Matthew;Spencer, Horace;Stack, Brendan C., Jr.
通讯作者：
Stack, Brendan C., Jr.
影响因子：
3.8
作者：
Al-Qurayshi, Z.;Srivastav, S.;Kandil, E.
通讯作者：
Kandil, E.
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
DOI：
10.1001/jama.2016.16885
发表时间：
2016-12-27
期刊：
JAMA
影响因子：
--
作者：
Dieleman JL;Baral R;Birger M;Bui AL;Bulchis A;Chapin A;Hamavid H;Horst C;Johnson EK;Joseph J;Lavado R;Lomsadze L;Reynolds A;Squires E;Campbell M;DeCenso B;Dicker D;Flaxman AD;Gabert R;Highfill T;Naghavi M;Nightingale N;Templin T;Tobias MI;Vos T;Murray CJ
通讯作者：
Murray CJ
影响因子：
3
作者：
Reinke, Caroline E.;Sonnenberg, Elizabeth M.;Kelz, Rachel R.
通讯作者：
Kelz, Rachel R.