Abstract
Objectives:
Evaluate healthcare use after the implementation of an algorithm to manage postoperative serum calcium in patients undergoing total or completion thyroidectomy.
Methods:
On June 1, 2010, standardized postoperative calcium monitoring algorithm was implemented at the University of Missouri for all patients undergoing total or completion thyroidectomies. Patients were selected for analysis if the following CPT codes were billed for their hospital stay: 60240, 60252, 60260, and 60271. Patient data were collected in a retrospective fashion for 18 months prior to and 18 months after the date of implementation. The three primary outcomes assessed were post-procedure length of stay, non-planned readmissions or emergency visits within 30 days, and readmissions specifically for hypocalcemia.
Results:
A total of 80 patients in the pre-algorithm group (December 1, 2008 - May 31, 2010) were compared with 102 patients in the post-algorithm group ( June 1, 2010 - December 31, 2011). The average length of stay went from 2.938 days to 1.5 days (p<0.0001). Total readmissions for all non-planned procedures and all emergency department visits within 30 days post-procedurally went from 11.25% to 6.86% of patients (p=0.2995). Readmissions for hypocalcemia went from 5% to 1% of patients (p=0.4071).
Conclusions:
Using a calcium monitoring algorithm postoperatively following total and completion thyroidectomy demonstrated a statistically significant decrease in the length of stay after procedure and a trend toward overall decrease in emergency department visits, all non-planned readmissions, and readmissions for symptomatic hypocalcemia.
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