title: The true cost of thyroid surgery determined by a micro-costing approach.
abstract: Whether the amount of the current DRG tariff for thyroid surgery covers its actual cost has been questioned. We estimated a reliable cost of thyroid surgery for a large Italian hospital. A micro-costing approach is used with data from the University Hospital "Umberto I," a large facility that conducts a high volume of thyroidectomy surgical procedures in the Lazio region. The direct costs of surgery and hospitalization for a total and a hemi-thyroidectomy were €4956 and €4673, respectively. When compared to the DRG tariff of €3340, total thyroidectomy was €1616 (48 %) more per procedure and hemi-thyroidectomy was €1333 (40 %) more per procedure. This DRG shortfall is calculated to generate an annual procedure-specific deficit of approximately €1.38 million for this hospital. Furthermore, when the costs associated with pre-surgical work-up, post-surgical follow-up, and complications management through 12 months are incorporated, the estimated costs of total and hemi-thyroidectomy rose to €5812 and €5277, respectively. The true cost of thyroid surgery in Italy is significantly higher than what has been reported in the literature or reimbursed by the DRG tariff.
authors.affiliation: Departments of Internal Medicine and Medical Specialties, "Sapienza" University of Roma, Viale del Policlinico 155, 00161, Rome, Italy. sebastiano.filetti@uniroma1.it.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Filetti
authors.affiliation: Departments of Medicine, Pathology, Oncology, and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Ladenson
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Biffoni
authors.affiliation: Ufficio Programmazione, AFC Programmazione, Governo Economico e Valutazione, Azienda Policlinico Umberto I, Roma, Viale del Policlinico 155, 00161, Rome, Italy.
authors.forename: Maria Giuseppina
authors.initials: MG
authors.lastname: D'Ambrosio
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Pharmacist, Health Economist, Via Anfossi 10, 35129, Padua, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Lopatriello
mesh_terms: D003365:Costs and Cost Analysis; D017048:Health Care Costs; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007558:Italy; D012051:Reimbursement Mechanisms; D013961:Thyroid Gland / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics*
keywords: Costs and cost analysis; Diagnosis-related groups; Healthcare costs; Italy; Reimbursement mechanisms; Thyroidectomy