Costs of outpatient thyroid surgery from the University HealthSystem Consortium (UHC) database.
OBJECTIVE
To compare the cost of same-day vs 23-hour observation outpatient thyroidectomy at US academic medical centers.


METHODS
Cross-sectional analysis of a national database.


METHODS
The University HealthSystem Consortium (UHC) data collected from discharge summaries.


METHODS
Discharge data were collected from the first quarter of 2009 through the second quarter of 2013. The UHC database, compiled from more than 200 affiliated hospitals, was searched based on diagnosis codes for outpatient thyroid procedures. Cost data, calculated based on reported charges, were collected in addition to demographics. Comparisons were made between same-day vs 23-hour observation based on cost. Additional stratification was performed based on the extent of thyroidectomy.


RESULTS
During the study period, 49,936 outpatient thyroidectomies were performed. Overnight observation (63%) was more common than same-day discharge (37%). The overall mean cost of outpatient thyroidectomy was $5617, with a mean cost of same-day surgery of $4642 compared with $6101 for overnight observation (P < .0001). When stratifying by extent of thyroidectomy, the cost of same-day surgery was consistently lower than that for overnight observation.


CONCLUSIONS
Outpatient thyroidectomy is commonly performed in the United States. It is most commonly performed on a 23-hour overnight observation basis. Overnight stay and complications were chief among other factors associated with higher cost, independent of the type of thyroid procedure performed. In appropriately selected patients, same-day thyroidectomy is a safe and cost-effective alternative to overnight observation or inpatient thyroid procedures.
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Matthew
M
Marino
Horace
H
Spencer
Sam
S
Hohmann
Donald
D
Bodenner
Brendan C
BC
Stack
D000556:Ambulatory Surgical Procedures / Q000191:economics*; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy / Q000191:economics*; D014481:United States
UHC; costs; database; discharge; outpatient thyroid surgery; overnight; same day