[Cost minimization analysis for the definitive therapy of hyperthyroidism: comparison of goiter resection with radioiodine therapy].
OBJECTIVE
Cost-analysis of strumaresection and radioiodine treatment in patients with hyperthyreosis.


METHODS
Matched by age, sex, comorbidity, volume of goiter, and entity of hyperthyreosis 18 patients of a clinic of surgery, and 28 patients of a clinic of nuclear medicine were analysed by the reimbursed costs, and by a retrospective calculation of the real costs.


RESULTS
Based on the rate for the reimbursed costs the radioiodine treatment (6450 DM) was more favourably than the strumaresection (7562 DM); based on the calculation of the real costs including regional specialities there was a minimal difference in favour of the strumaresection (5185 DM versus 5562 DM) because of the selection of large goiters (median 53 ml), the longer hospitalisation after radioiodine treatment due to legal reasons (12.5 days), and the frequent controls before and after the radioiodine treatment. Most important cost-factor of the radioiodine treatment was the volume of goiter, most important cost-factor of the strumaresection was the age of the patient. The treatment of Graves disease was more expensive than that of autonomy in surgery as well as in nuclear medicine.


CONCLUSIONS
In order to achieve cost-minimization, radioiodine treatment should be prefered in cases of small goiters or in older patients.
Dietlein
M
M
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln.
Geckle
L
L
Overbeck
T
T
Moka
D
D
Bausch
V
V
Troche
C J
CJ
Lauterbach
K
K
Schicha
H
H
D003362:Cost-Benefit Analysis; D005858:Germany; D006042:Goiter / Q000191:economics / Q000532:radiotherapy* / Q000601:surgery*; D006111:Graves Disease / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D006760:Hospitalization / Q000191:economics; D006801:Humans; D006980:Hyperthyroidism / Q000191:economics / Q000532:radiotherapy* / Q000601:surgery*; D007457:Iodine Radioisotopes / Q000191:economics / Q000627:therapeutic use*; D007902:Length of Stay; D013965:Thyroidectomy / Q000191:economics*
D007457:Iodine Radioisotopes