Variation in cost of total thyroidectomy across the United States, 2007 to 2008
Variation in cost of total thyroidectomy across the United States, 2007 to 2008
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DOI：
10.1016/j.amjsurg.2014.12.039
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发表时间：
2015-08-01
影响因子：
3
通讯作者：
Kelz, Rachel R.
中科院分区：
文献类型：
--
作者：
Reinke, Caroline E.;Sonnenberg, Elizabeth M.;Kelz, Rachel R.
背景：对各州手术护理费用的变化知之甚少。我们试图研究州一级的工资调整总成本（WATC）的变化，一个共同的外科手术processing.METHODS：我们进行了一项回顾性队列研究，患者接受甲状腺全切除术在全国住院患者样本（2007年至2008年）。WATC是根据收费计算的，并根据地区工资指数进行了调整。分层线性模型被用来调查在病人，医院和国家level.RESULTS的变量解释的变化在WATC：我们确定了11,058名合格的患者从35个州。整体平均WATC为8,132美元; 37%的WATC方差是因为不同的医院，而28%是由患者水平的因素和8%的差异，因为跨states.Conclusions的差异解释：超过四分之一的甲状腺全切除术的费用的变化是不能解释的患者，医院，或国家水平的因素。需要进一步的研究来了解无法解释的残差变异。(C)2015 Elsevier Inc. All rights reserved.
BACKGROUND: Variation in cost of surgical care across state lines is poorly understood. We sought to examine state- level variation in wage-adjusted total cost (WATC) of a common surgical procedure.METHODS: We performed a retrospective cohort study of patients undergoing total thyroidectomy in the Nationwide Inpatient Sample (2007 to 2008). WATC was calculated from charges and adjusted for the area wage index. Hierarchical linear modeling was used to investigate the variation in WATC explained by variables at the patient, hospital, and state levels.RESULTS: We identified 11,058 eligible patients from 35 states. The overall mean WATC was $8,132; 37% of the WATC variance was because of differences across hospitals, whereas 28% was explained by patient-level factors and 8% because of differences across states.CONCLUSIONS: More than a quarter of the variation in cost of total thyroidectomy was not explained by patient-, hospital-, or state-level factors. Further research is needed to understand the unexplained residual variation. (C) 2015 Elsevier Inc. All rights reserved.