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Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
Endocrine surgery as a model for value-based health care delivery
Amer G Abdulla1, Philip H G Ituarte, Randi Wiggins
1Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Surgical Neurology International
|February 2, 2013
Summary
Implementing a value-based healthcare system at UCLA
Area of Science:
- Health Economics
- Surgical Outcomes
- Value-Based Care
Background:
- Experts recommend transitioning US healthcare to a value-based system.
- The UCLA Section of Endocrine Surgery (SES) implemented a value-based system to improve outcomes and costs.
- This system successfully optimized quality and costs while increasing patient volume.
Purpose of the Study:
- To evaluate the impact of a value-based healthcare system on quality and costs in endocrine surgery.
- To assess the effectiveness of clinical pathways in optimizing care delivery.
- To analyze the impact of specific surgical techniques on patient outcomes.
Main Methods:
- Compared costs across tertiary inpatient, community inpatient, and ambulatory care settings (2005-2010).
- Assessed papillary thyroid carcinoma (PTC) patient outcomes, comparing central neck dissection (CND) versus no CND.
- Analyzed surgical patient volume and regional market share over time.
Main Results:
- Ambulatory facilities showed 58% cost savings; community inpatient facilities showed 14% savings compared to tertiary care.
- Patients undergoing CND had significantly lower thyroglobulin (Tg) levels and reduced reoperation rates.
- UCLA expanded its endocrine surgery market share by 151%, maintaining market leadership.
Conclusions:
- A value-driven system improved clinical outcomes and reduced costs in endocrine surgery.
- The UCLA SES model demonstrates successful implementation of value-based principles.
- Broader adoption of these principles could address national healthcare challenges.
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