Health services research in endocrine surgery.
OBJECTIVE
We review recent health services research studies examining clinical and economic outcomes in endocrine surgery.


RESULTS
Recent studies have focused on such important issues as the use of the Internet in medicine, patient quality of life, cost-effectiveness of emerging surgical technologies, and labor-force modeling. There is a need for accurate and informative websites dedicated to thyroid disease, given the large number of patients who use the Internet for healthcare information. Debate continues about the relative merits of medical and surgical therapy for primary hyperparathyroidism; based on measurements of quality of life and cost-effectiveness, parathyroidectomy appears to be favored. Surgical outcomes studies have shown parathyroidectomy to be safe in octogenarian and nonagenarian patients with primary hyperparathyroidism. Sophisticated work-force projections suggest that the supply of endocrine surgeons will grow over the next 15 years, but will be outpaced by the anticipated demand.


CONCLUSIONS
Health services research is a burgeoning field of investigation in endocrine surgery. It needs to be developed to improve the quality of care of patients with thyroid, parathyroid, adrenal and endocrine pancreatic diseases.
Roman
Sanziana
S
Section of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06520, USA. sanziana.roman@yale.edu
Boudourakis
Leon
L
Sosa
Julie A
JA
D000310:Adrenal Gland Neoplasms / Q000601:surgery; D013507:Endocrine Surgical Procedures / Q000191:economics / Q000379:methods; D004700:Endocrine System Diseases / Q000601:surgery*; D006302:Health Services Research; D006801:Humans; D017063:Outcome Assessment, Health Care; D010190:Pancreatic Neoplasms / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000601:surgery; D019984:Quality Indicators, Health Care; D013961:Thyroid Gland / Q000601:surgery