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Should total thyroidectomies be performed by high-volume endocrine surgeons? A cost-effectiveness analysis
Panagiotis Anagnostis1, Ioannis Pliakos2, Stavros Panidis2,3
1Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. pan.anagnostis@gmail.com.
Endocrine
|September 22, 2019
Summary
High-volume thyroid surgeons (HVS) are more cost-effective than low-volume surgeons (LVS) for total thyroidectomy. This is due to fewer postoperative complications, leading to lower overall healthcare costs.
Area of Science:
- Surgical Oncology
- Health Economics
Background:
- Surgeon experience is linked to reduced postoperative complications in thyroidectomy.
- The cost-effectiveness of high-volume surgeons (HVS) versus low-volume surgeons (LVS) for total thyroidectomy remains unestablished.
Purpose of the Study:
- To compare the cost-effectiveness of total thyroidectomy performed by HVS versus LVS.
Main Methods:
- Retrospective study comparing mean total thyroidectomy costs per patient between HVS and LVS.
- Costs included surgical procedure and inpatient hospitalization (pre- and post-operative).
- High-volume surgeons were defined as performing ≥25 thyroidectomies/year.
Main Results:
- Higher rates of temporary hypoparathyroidism and airway compromise were observed in the LVS group.
- Mean total cost per patient was significantly higher for LVS (€1721 ± 396) compared to HVS (€979 ± 68).
- Cost differences were driven by surgical procedure expenses and postoperative inpatient hospitalization.
Conclusions:
- Total thyroidectomy by HVS appears more cost-effective than by LVS.
- Reduced surgical complication rates (e.g., hypoparathyroidism, airway obstruction) contribute to the cost-effectiveness of HVS.
