Costs of Outpatient Thyroid Surgery from the University HealthSystem Consortium (UHC) Database
Costs of Outpatient Thyroid Surgery from the University HealthSystem Consortium (UHC) Database
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DOI：
10.1177/0194599814521583
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发表时间：
2014-05-01
影响因子：
3.4
通讯作者：
Stack, Brendan C., Jr.
中科院分区：
文献类型：
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作者：
Marino, Matthew;Spencer, Horace;Stack, Brendan C., Jr.
目的比较美国学术医疗中心门诊甲状腺切除术当天与23小时观察的费用。研究设计：国家数据库的横断面分析。设置大学健康系统联盟（UHC）的数据收集从出院摘要。受试者和方法出院数据收集从2009年第一季度到2013年第二季度。根据门诊甲状腺手术的诊断代码，检索了从200多家附属医院编制的UHC数据库。除了人口统计数据外，还收集了根据报告的费用计算的费用数据。根据成本比较了当天与23小时观察。根据甲状腺切除术的范围进行额外的分层。结果在研究期间，共进行了49，936例门诊甲状腺切除术。过夜观察（63%）比当天出院（37%）更常见。门诊甲状腺切除术的总平均费用为5617美元，当天手术的平均费用为4642美元，而过夜观察的平均费用为6101美元（P <0.0001）。当按甲状腺切除范围分层时，当天手术的费用始终低于过夜观察的费用。结论门诊甲状腺切除术在美国是常见的。它通常在23小时过夜观察的基础上进行。过夜住院和并发症是与较高费用相关的主要因素，与所进行的甲状腺手术类型无关。在适当选择的患者中，当天甲状腺切除术是过夜观察或住院甲状腺手术的安全且具有成本效益的替代方案。
Objective To compare the cost of same-day vs 23-hour observation outpatient thyroidectomy at US academic medical centers. Study Design Cross-sectional analysis of a national database. Setting The University HealthSystem Consortium (UHC) data collected from discharge summaries. Subjects and Methods Discharge data were collected from the first quarter of 2009 through the second quarter of 2013. The UHC database, compiled from more than 200 affiliated hospitals, was searched based on diagnosis codes for outpatient thyroid procedures. Cost data, calculated based on reported charges, were collected in addition to demographics. Comparisons were made between same-day vs 23-hour observation based on cost. Additional stratification was performed based on the extent of thyroidectomy. Results During the study period, 49,936 outpatient thyroidectomies were performed. Overnight observation (63%) was more common than same-day discharge (37%). The overall mean cost of outpatient thyroidectomy was $5617, with a mean cost of same-day surgery of $4642 compared with $6101 for overnight observation (P < .0001). When stratifying by extent of thyroidectomy, the cost of same-day surgery was consistently lower than that for overnight observation. Conclusion Outpatient thyroidectomy is commonly performed in the United States. It is most commonly performed on a 23-hour overnight observation basis. Overnight stay and complications were chief among other factors associated with higher cost, independent of the type of thyroid procedure performed. In appropriately selected patients, same-day thyroidectomy is a safe and cost-effective alternative to overnight observation or inpatient thyroid procedures.