Mapping the centers performing endocrine neck surgery in Italy.

Area of Science:

• Endocrine Surgery
• Health Services Research
• Surgical Outcomes

Background:

• Provider experience and quality of care are closely linked in surgery.
• Classifying surgical centers by procedure volume is crucial for quality assessment.
• Endocrine neck surgery, including thyroidectomy and parathyroidectomy, requires specialized expertise.

Purpose of the Study:

• To develop and validate a method for classifying centers performing endocrine neck surgery based on procedure volume.
• To identify centers of excellence, alert, and risk for thyroidectomy and parathyroidectomy.
• To provide data for optimizing healthcare organization in endocrine neck surgery.

Main Methods:

• Descriptive statistical analysis of 666 Italian centers performing endocrine neck surgery in 2015.
• Identification and exclusion of outlier centers based on predefined thyroidectomy and parathyroidectomy volumes.
• Classification of remaining centers into 'excellence', 'alert', and 'risk' zones using the Standardized Hospitalization Ratio (SHR).

Main Results:

• In 2015, 35,743 thyroidectomies and 2,306 parathyroidectomies were performed in Italy.
• After outlier exclusion, 407 and 157 centers were analyzed for thyroidectomy and parathyroidectomy, respectively.
• The study identified 95 excellence centers for thyroidectomy and 33 for parathyroidectomy, with a significant number falling into 'risk' zones.

Conclusions:

• The developed method effectively highlights the volume of endocrine neck surgeries performed in low-volume centers.
• Healthcare organizations can implement tutorship programs where 'excellence' centers support 'alert' centers.
• Discouraging 'risk' centers from performing endocrine neck surgery may improve overall quality of care.