Institute of Clinical Epidemiology, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Magdeburger Str. 8, 06097, Halle (Saale), Germany.
Langenbecks Arch Surg. 2012 Mar;397(3):421-8. doi: 10.1007/s00423-011-0897-1. Epub 2012 Jan 10.
In 2004, a Diagnosis Related Groups (DRG)-based hospital reimbursement system became mandatory in Germany. The aim of this study was to provide nationwide data on the surgery of thyroid cancer by analyzing DRG statistics of the years 2005 and 2006.
The unit of analysis was hospital admission with a diagnosis of thyroid cancer. We assessed the influence of age, sex and region on the relative frequency of thyroid cancer-related hospitalisations with surgery of the thyroid and we measured the association between hospitalisation rates and incidence rates of thyroid cancer among the Federal States of Germany.
Over the period 2005 to 2006, 11,107 thyroid cancer-associated hospitalisations included surgical treatment of the thyroid. The age-standardised DRG-based hospitalisation rates and the corresponding cancer registry-based incidences of thyroid cancer were positively associated. Overall, 68% of the hospitalisations with thyroid surgery included a total thyroidectomy. The percentage of surgery of the thyroid with a total thyroidectomy was nearly identical among men and women, decreased among men aged over 60 and varied considerably by region (minimum, 48% in Saarland; maximum, 78% in Saxony-Anhalt).
Our analyses of DRG statistics provide for the first time representative population-based data of the surgical management of thyroid cancer patients in Germany. Despite an identical health care system all over Germany and existing guidelines for surgical treatment of thyroid cancer, we observed a considerable regional variation in the proportion of total thyroidectomies performed in Germany.
2004 年，德国开始强制实行基于诊断相关分组（DRG）的医院报销制度。本研究旨在通过分析 2005 年和 2006 年的 DRG 统计数据，提供全国范围内甲状腺癌手术的数据。
分析单位是诊断为甲状腺癌的住院病例。我们评估了年龄、性别和地区对甲状腺癌相关住院手术的相对频率的影响，并测量了德国联邦州的住院率与甲状腺癌发病率之间的相关性。
在 2005 年至 2006 年期间，共有 11107 例甲状腺癌相关住院病例接受了甲状腺手术治疗。年龄标准化的基于 DRG 的住院率与基于癌症登记的甲状腺癌发病率呈正相关。总体而言，68%的甲状腺手术住院病例包括全甲状腺切除术。男女之间全甲状腺切除术的比例几乎相同，60 岁以上男性的比例下降，且地区差异很大（最低为萨尔州的 48%，最高为萨克森-安哈尔特州的 78%）。
我们对 DRG 统计数据的分析首次提供了德国甲状腺癌患者手术管理的代表性基于人群的数据。尽管德国各地的医疗保健系统相同，且存在甲状腺癌手术治疗的指南，但我们观察到德国全甲状腺切除术的比例存在相当大的地区差异。
