Key result
Ambulatory total thyroidectomy is linked to ~$2367 lower costs vs overnight admission without increasing complications.
Why the study?
To compare the financial impact and associated surgical outcomes between patients undergoing ambulatory versus overnight admission after total thyroidectomy.
Does ambulatory surgery reduce costs and maintain safety compared to overnight observation in patients undergoing total thyroidectomy?
Observational (n=870)
No
Does ambulatory surgery reduce costs and maintain safety compared to overnight observation in patients undergoing total thyroidectomy?
Outpatient total thyroidectomy significantly reduces costs by an average of $2367 per patient without increasing complication rates compared to overnight admission.
Answers are grounded in this paper and cite their sources.
May support ambulatory thyroidectomy for lower costs without added complications; leaves open need for randomized confirmation before practice change.
Objective To compare financial impact between patients undergoing ambulatory (same‐day discharge) vs overnight admission after total thyroidectomy while showing associated surgical outcomes. Study Design Retrospective review. Setting University of Alabama at Birmingham Medical Center from October 2011 and July 2017. Methods Patients undergoing total thyroidectomy without concurrent procedures were selected for review. Demographics, comorbidities, admission status, postoperative outcomes including minor and major complications, charges, and costs were collected. Admission status was categorized as inpatient (admission to hospital ≥1 night) or outpatient (discharged from the postoperative recovery unit). Costs were obtained from all related hospital, clinic, and emergency department visits at the University of Alabama at Birmingham within 30 days of the original surgery. After statistical analysis, outcomes and costs were compared between inpatient and outpatient total thyroidectomy patients. Results Of 870 total thyroidectomy patients included for analysis, 367 (42.2%) met outpatient criteria. A total of 169 patients (19.4%) had a complication, and only hypocalcemia occurred significantly more in the inpatient group (14.3% vs 9.26%; P <. 05). No complications occurred more frequently in the outpatient population. There were no mortalities. There was a statistically significant difference between the total cost of inpatient and outpatient thyroidectomies, with outpatient surgery costing on average $2367.27 less per patient ( P <. 0001). Conclusion Outpatient total thyroidectomy can lead to cost reduction in highly selected patients who have few comorbidities while remaining safe for the patient.
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Rosen et al. (2021) conducted an observational in Total thyroidectomy (n=870). Ambulatory (same-day discharge) total thyroidectomy vs. Overnight admission (inpatient) total thyroidectomy was evaluated on Total cost (-$2367.27, p=<0.0001). Ambulatory total thyroidectomy cost on average $2367.27 less per patient compared to overnight admission, with no increase in complications.
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