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Surge in hospital costs after thyroid surgery seen 2003 to 2011
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The cost of a hospital stay following thyroid surgery increased dramatically between 2003 and 2011, according to recent findings.
In the retrospective, cross-sectional study, Vincent L. Biron, MD, PhD, FRCS(C), of the University of Alberta, and colleagues reviewed the Nationwide Inpatient Sample database for discharge data on all admission subsequent to thyroid lobectomy or total thyroidectomy. The data were extracted for the years 2003, 2007 and 2011. The researchers identified cost as the dependent variable, and independent variables included demographic characteristics, diagnostic and procedural information, hospital characteristics and postoperative complications. They used a generalized linear model to determine factors independently linked to high hospital costs.
Vincent L. Biron
A factor was deemed related to high costs if it was significantly associated (beta coefficient > 1) with higher cost over 2 of the 3 years evaluated. The researchers then assessed patterns in the number of admissions associated with any of these high-cost drivers.
The researchers determine that there were 47,854 hospital admissions after a total thyroidectomy or thyroid lobectomy in the years 2003, 2007 and 2011. There was a significant cumulative increase in national hospital costs from $198 million in 2003 to $373 million in 2011, after adjusting for inflation. There was an increase in mean cost of hospitalization after thyroid surgery during the study period from $6,154 to $8,982 from 2003 to 2011, after adjusting for inflation in 2011 dollars.
The following factors were found to be associated with increased hospital costs: higher morbidity score, total thyroidectomy, lymphadenectomy, western region, rural area and postoperative complications. The factors identified as the most likely causes of the cost increase over the study interval were an increased percentage of patients with higher severity of illness score and an increased percentage of patients undergoing total thyroidectomy and lymphadenectomy.
According to the researchers, this is the first study to evaluate the factors involved in increased hospital costs following inpatient thyroid surgery.
“Continued increases in the proportion of sicker patients and the rate of malignancy are likely to continue driving hospital costs higher,” the researchers wrote. “The clinical implications of the increasing use of total thyroidectomy and lymphadenectomy should be further examined as this may present an opportunity to limit further cost increases.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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