Abstract
Objectives:
Compare the cost of outpatient and inpatient thyroidectomy at US academic medical centers.
Methods:
Discharge data were collected from the first quarter of 2009 through the fourth quarter of 2012 from the University Health System Consortium (UHC) on over 50,000 patients. The UHC database, compiled from over 100 academic health centers and their 200 affiliated hospitals, was searched based on diagnosis codes for outpatient and inpatient thyroid procedures. The Agency for Healthcare and Research Quality (AHRQ) chronic conditions were collected in addition to demographic, length of stay (LOS), and cost data. Comparisons were made between inpatient and outpatient thyroidectomy stratified by number of chronic conditions.
Results:
The cost of outpatient thyroidectomy was consistently less than that for inpatient thyroidectomy. More outpatient thyroidectomies were performed on patients with 0 or 1 chronic condition, while more inpatient thyroidectomies were performed on patients with 2 or greater chronic conditions. When stratifying by number of chronic conditions, the cost of outpatient thyroidectomy remained stable independent of the number of additional conditions. However, the cost of inpatient thyroidectomy rose linearly with an increased number of chronic conditions.
Conclusions:
Outpatient thyroid surgery is associated with less cost when compared with inpatient thyroid surgery, and the difference in cost rises with number of chronic conditions present. The transition to outpatient thyroid surgery may provide significant cost-savings, particularly in those patients with chronic conditions. However, certain chronic conditions may preclude patients from undergoing outpatient surgery.
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