Collier Karole, Sataloff John, Wirtalla Chris, Kuo Lindsay, Karakousis Giorgos C, Kelz Rachel R
Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA.
Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA.
Am J Surg. 2017 Sep;214(3):501-508. doi: 10.1016/j.amjsurg.2017.01.008. Epub 2017 Jan 10.
In anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions.
Patients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Primary outcome was readmission within 90 days. Univariate and multivariable logistic regression were used to determine factors associated with readmission. Subset analysis was performed for thyroid cancer patients.
Among 59,427 patients, 34.2% had thyroid cancer. Eleven percent (n = 6462) were readmitted within 90 days, with 27% readmitted to a different hospital than the index. 66.2% of thyroid cancer patients were readmitted for a related condition.
Eleven percent of patients are admitted to the hospital within 90 days of an operation in the thyroid or parathyroid glands. Patient factors and diseases necessitate the use of hospital services. Bundled payments must consider the patients' needs for hospital-based services in calculating costs for surgically treated endocrine disorders.
鉴于甲状腺和甲状旁腺疾病的捆绑支付模式，需要更好地了解手术后的资源利用情况。我们试图通过分析再入院情况来描述此类手术后医院服务的使用情况。
对2008 - 2011年在加利福尼亚州或纽约州接受甲状腺或甲状旁腺手术的18岁及以上患者按手术类型进行分类。主要结局是90天内再入院。采用单因素和多因素逻辑回归确定与再入院相关的因素。对甲状腺癌患者进行亚组分析。
在59427例患者中，34.2%患有甲状腺癌。11%（n = 6462）在90天内再次入院，其中27%在不同于初次入院的医院再次入院。66.2%的甲状腺癌患者因相关疾病再次入院。
11%的患者在甲状腺或甲状旁腺手术后90天内再次入院。患者因素和疾病需要使用医院服务。捆绑支付在计算手术治疗内分泌疾病的成本时必须考虑患者对医院服务的需求。
