Variación estatal del gasto por episodio de tiroidectomía para cáncer de tiroides de bajo riesgo

This study aimed to evaluate variation in spending for thyroidectomy for patients with thyroid cancer.

This retrospective cohort study analyzed risk-adjusted, price-standardized Michigan-based claims data from 2015 to 2022 and included patients who underwent thyroidectomy for lower-risk thyroid cancer. The primary outcome was 90-day spending. A mixed linear model with facility as a random effect identified factors associated with spending variability.

In total, 2516 patients underwent thyroidectomy at 81 facilities. Unadjusted 90-day spending ranged from $5917 to $25,630 across facilities (median $8993). Spending was lowest for lobectomy (median $7755) and highest for lobectomy followed by completion thyroidectomy (median $14,181). On regression, factors significantly associated with increased spending were patient age and readmission. The interaction between occurrence of post-operative complications and lengths of stay >2 nights contributed to dramatically higher spending.

Reducing complications and associated length of stay as well hospital readmissions represent opportunities to improve the value of thyroidectomy.