Key result
High surgeon volume reduces complications while high hospital volume lowers length of stay and costs.
Why the study?
The impact of surgeon and hospital volume on quality of care and costs in endocrine neck surgery lacks clear consensus on procedure thresholds for safety and economic outcomes.
Does high surgeon or hospital volume improve outcomes and reduce costs in endocrine neck surgery?
Systematic Review (n=22)
Does high surgeon or hospital volume improve outcomes and reduce costs in endocrine neck surgery?
Higher surgeon and hospital volumes in endocrine neck surgery are associated with fewer complications and lower costs, with specific annual volume cut-offs suggested for optimal outcomes.
Supports selective referral to high-volume thyroid surgeons and hospitals; extends volume-outcome data to endocrine neck surgery.
The relationship between quality of care and provider's experience is well known in all fields of surgery. Even in thyroidectomies and parathyroidectomies, the emphasis on positive volume-outcome relationships is believed. It led us to an evaluation of volume activity's impact in terms of quality of care. A systematic narrative review was performed. According to the PRISMA criteria, we selected 87 paper and, after the study selection was performed, 22 studies were finally included in this review. All articles included were unanimous in attributing to activity volume of surgeons as well as centers a substantial importance. Some differences in outcomes between these investigated categories have been found: best results of the high volume surgeon is evident expecially in terms of complications, on the contrary best outcomes of a high volume center are mainly economics, such as hospital stay and general costs of the procedures. A cut-off of 35-40 thyroidectomies per year for single surgeon, and 90-100 thyroidectomies for single center appears reasonable for identifying an adequate activity. Concerning parathyroidectomy, we can consider reasonable a cut off at 10-12 operations/year. More studies are needed in a European or more circumscribed perspective.
No takes yet. Share an insight, caveat, or question.
Giuseppina Melfa (2018) conducted a systematic review in Endocrine neck surgery (thyroidectomies and parathyroidectomies) (n=22). High surgeon and hospital volume vs. Low volume was evaluated on Quality of care (complications, hospital stay, and general costs). High surgeon volume (≥35-40 thyroidectomies/year) improves complication rates, while high hospital volume (≥90-100/year) improves economic outcomes like hospital stay and costs.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: