Abstract
Comparison of inpatient and outpatient thyroidectomy: a multi-states analysis
Journal of the American College of Surgeons, Vol.221(4), pp.e11-e11
10/2015
DOI: 10.1016/j.jamcollsurg.2015.08.323
Abstract
Introduction
Increasingly outpatient thyroidectomy (OT) is performed instead of inpatient thyroidectomy (IT). In this study, we aim to examine the demographic and clinical factors associated with patients undergoing OT compared to IT.
Methods
A cross-sectional study, 2007-2010. Inpatients and outpatients were selected from the Healthcare Cost Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) and State Ambulatory Surgery and Services Databases (HCUP-SASD), respectively. All patients were adult (≥18 years) who underwent thyroidectomy in the States of Florida and New York.
Results
29,962 patients were included. 22,425 (74.8%) underwent OT, while the rest (25.2%) had IT. Patients who had OT were more likely to be females, had private insurance, or those with body mass index <25 kg/m2 (p<0.001 each). Compared to Whites, Blacks were less likely to have OT (p<0.001); while Hispanics were more likely to undergo OT (p=0.009). Unilateral thyroidectomies performed for thyroid conditions other than malignancy were most common in the outpatient settings (p<0.05 each). High-volume surgeons (≥ 100 thyroidectomies/year) are more likely to perform ambulatory thyroidectomy (p<0.001). Postoperative complications risk was lower for OT compared to IT [OR: 0.51, 95% CI: (0.46, 0.58), p<0.001]. However, among OT the risk was higher for low-volume surgeons (<100 thyroidectomies/year) [OR: 1.89, 95% CI: (1.47, 2.44), p<0.001]. Moreover, hospital charges for OT performed by low-volume surgeons were significantly >$29,873.00 compared to high-volume surgeons (p<0.001).
Conclusions
A racial and economic disparities exist in the utilization of outpatient thyroidectomy. Experienced surgeons are more likely to provide ambulatory thyroidectomy, and surgeries done by them are associated with more favorable outcomes and less hospital charges.
Details
- Title: Subtitle
- Comparison of inpatient and outpatient thyroidectomy: a multi-states analysis
- Creators
- Zaid Al-QurayshiEmad Kandil - Tulane University
- Resource Type
- Abstract
- Publication Details
- Journal of the American College of Surgeons, Vol.221(4), pp.e11-e11
- Publisher
- ELSEVIER SCIENCE INC
- DOI
- 10.1016/j.jamcollsurg.2015.08.323
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702897602771
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