甲状腺がんに対する甲状腺摘出術の州ごとのエピソード支出のばらつき

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.