title: Economic impact of and satisfaction with a high resolution thyroid nodule clinic at the endocrinology department.
abstract: OBJECTIVE
  No conclusive data exist on the value of a high resolution thyroid nodule clinic for management of nodular thyroid disease. The aim of this study was to evaluate the economic impact of and user satisfaction with a high resolution thyroid nodule clinic (HRTNC) in coordination with primary care.
  
  
  METHODS
  A prospective, observational, descriptive study was conducted to analyze data from 3,726 patients (mean age 61±12 years; 85% women) evaluated at an HRTNC during 2014 and 2015. Demographic data (sex and age), number of ultrasound examinations and fine needle aspiration cytologies (FNAC), referral center and consultation type were assessed.
  
  
  RESULTS
  In 2014 and 2015, 3,726 neck ultrasound examinations and 926 FNACs (3.8% rated as non-diagnostic) were performed. Among the 1,227 patients evaluated for the first time, 21.5% did not require a second endocrine appointment, which resulted in mean estimated savings of 14,354.55 euros. Of all patients, 41.1% were referred from primary care, 33.4% from endocrinology, and 26.5% from other specialties. As compared to 2013, the number of thyroid ultrasound examinations requested decreased by 65.3% and 59.7% in 2014 and 2015 respectively, with mean estimated savings of 137,563.92 euros. Mean user satisfaction assessed was 4.0 points (95% confidence interval, 3.7-4.3) on a 5-point scale.
  
  
  CONCLUSIONS
  HRTNCs at endocrinology departments, coordinated with primary care, are a viable, cost-effective alternative with a positive user perception.
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España. Electronic address: diazsotogonzalo@gmail.com.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Díaz-Soto
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Torres
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: López Gómez
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Emilia
authors.initials: E
authors.lastname: Gómez Hoyos
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Villar
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: Romero
authors.affiliation: Consulta Alta Resolución Patología Tiroidea, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, IEN-Universidad de Valladolid, Valladolid, España.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: de Luis
mesh_terms: D003362:Cost-Benefit Analysis; D004704:Endocrinology; D006748:Hospital Departments; D006801:Humans; D010549:Personal Satisfaction; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000191:economics / Q000473:pathology; D014463:Ultrasonography
keywords: Alta resolución; Citology; Citología; Costes; Costs; High resolution clinic; Nódulo tiroideo; Satisfacción; Satisfaction; Thyroid nodule