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Updated: Jun 10, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

Patient Neighborhood Adversity Associated With Access Not Wait Time to Parathyroidectomy.

Markayle Schears¹, Courtney Balentine², Rebecca Sippel²

¹University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

The Journal of Surgical Research

|October 19, 2024

Summary

Patients from socially deprived areas had lower parathyroidectomy rates but no significant surgical delays for primary hyperparathyroidism (PHPT). Socioeconomic status impacts access but not necessarily treatment timelines for those receiving care.

Keywords:

Adversity Delay Parathyroidectomy Primary hyperparathyroidism Social determinants Wait time to surgery

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Area of Science:

Endocrinology
Health Services Research
Socioeconomic Determinants of Health

Background:

Primary hyperparathyroidism (PHPT) treatment delays worsen patient morbidity, disproportionately affecting underserved populations.
Health disparities are linked to socioeconomic factors, potentially increasing surgical wait times for PHPT patients.

Purpose of the Study:

To investigate if patients with PHPT from socially and economically deprived areas experience longer surgical wait times.
To analyze the association between the Area Deprivation Index (ADI) and delays in parathyroidectomy for PHPT.

Main Methods:

Retrospective analysis of 1132 PHPT patients undergoing parathyroidectomy (2013-2022) at a tertiary care center.
Patients categorized into deciles based on the Area Deprivation Index (ADI), reflecting 17 social determinants of health.
Linear regression used to compare time from first hypercalcemic value to surgery across ADI groups, controlling for care process factors.

Main Results:

Patients from high-disadvantage areas were more likely to be rural and have higher comorbidity rates.
Despite lower-than-expected parathyroidectomy rates in the high-disadvantage group, the median time to surgery was similar across all ADI groups.
No significant association found between ADI and treatment delay (median 527 days for high-disadvantage vs. 633-657 days for others).

Conclusions:

While socioeconomic factors may influence access to care for PHPT, they do not appear to prolong surgical treatment for patients who ultimately receive care.
The study highlights that established care pathways mitigate delays associated with social determinants of health in PHPT treatment.