Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A; Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Laryngoscope. 2013 Dec;123(12):3239-42. doi: 10.1002/lary.24065. Epub 2013 Apr 1.
OBJECTIVES/HYPOTHESIS: To determine trends in office visits and medical specialty seen for surgical diagnoses of the thyroid gland.
A cross-sectional analysis of a national healthcare database.
From the National Ambulatory Medical Care Survey (NAMCS), all cases of surgical thyroid disorders (e.g., benign neoplasm of thyroid gland, malignant neoplasm of thyroid gland, multinodular goiter) were extracted for 2 calendar year cohorts: 1995 to 1999 and 2005 to 2009. In addition to demographic information, the medical specialty of the health care provider seen was extracted. Comparisons were conducted for the proportion of surgical thyroid cases seen between general surgeons and otolaryngologists for the respective cohorts.
In the 1995 to 1999 cohort, there were a total of 107 ± 13 thousand outpatient visits annually to either general surgery or otolaryngology for surgical thyroid conditions. Among these, 62.7 ± 8.4 thousand visits (58.3 ± 5.6%) were seen by general surgery versus 44.8 ± 9.1 thousand (41.7 ± 5.6%) seen by otolaryngology. In comparison, in the 2005 to 2009 cohort, there were 218 ± 29 thousand visits annually for surgical thyroid conditions. Among these, 88.4 ± 17 thousand (40.5 ± 5.4%) were seen by general surgery versus 130 ± 21 thousand (59.5 ± 5.4%) seen by otolaryngology. The increase in proportion of surgical thyroid patients seen by otolaryngology in the second 5 year cohort was statistically significant (P = 0.032, chi-square).
There is a national trend in the United States toward otolaryngologists seeing an increasing majority proportion of increasingly prevalent surgical thyroid conditions. These data objectively confirm the perceived increasing role of otolaryngologists in the management of surgical thyroid disorders on a national level.
目的/假设：确定因甲状腺外科诊断而就诊的门诊次数和就诊科室的趋势。
国家医疗保健数据库的横断面分析。
从国家门诊医疗调查（NAMCS）中提取 1995 年至 1999 年和 2005 年至 2009 年两个日历年度队列中所有甲状腺外科疾病（例如甲状腺良性肿瘤、甲状腺恶性肿瘤、多结节性甲状腺肿）的手术病例。除了人口统计学信息外，还提取了就诊医疗保健提供者的医疗专业信息。比较了两个队列中普外科医生和耳鼻喉科医生诊治甲状腺外科病例的比例。
在 1995 年至 1999 年的队列中，每年有 107,000±13,000 人次因甲状腺外科疾病就诊普外科或耳鼻喉科。其中，62700±8400 人次（58.3±5.6%）由普外科诊治，44800±9100 人次（41.7±5.6%）由耳鼻喉科诊治。相比之下，在 2005 年至 2009 年的队列中，每年有 218000±29000 人次因甲状腺外科疾病就诊。其中，88400±17000 人次（40.5±5.4%）由普外科诊治，130000±21000 人次（59.5±5.4%）由耳鼻喉科诊治。在第二个 5 年队列中，耳鼻喉科诊治的甲状腺外科患者比例增加具有统计学意义（P=0.032，卡方检验）。
在美国，耳鼻喉科医生诊治越来越多的甲状腺外科疾病的比例呈上升趋势。这些数据客观地证实了在全国范围内，耳鼻喉科医生在甲状腺外科疾病管理中的作用不断增强。
