Papini Enrico, Basile Michele, Novizio Roberto, Paoletta Agostino, Persichetti Agnese, Samperi Irene, Scoppola Alessandro, Crescenzi Anna, D'Amore Annamaria, Deandrea Maurilio, Frasoldati Andrea, Garberoglio Roberto, Guglielmi Rinaldo, Mauri Giovanni, Lombardi Celestino Pio, Puglisi Soraya, Rago Teresa, Triggiani Vincenzo, Van Doorne Dominique, Salvatore Domenico, Saulle Rosella, Attanasio Roberto
Endocrinology, Ospedale Regina Apostolorum, Albano Laziale, Italy.
High School of Economy and Management of Health Systems, Catholic University of Sacred Heart, Rome, Italy.
J Endocrinol Invest. 2025 May 22. doi: 10.1007/s40618-025-02597-2.
Benign thyroid nodules are common in adults, with incidental detection rates reaching 50-60% in women. While most nodules are asymptomatic and require no treatment, some grow and cause compressive symptoms.
This study evaluates the economic impact of various treatment modalities for benign thyroid nodules within the Italian healthcare system, comparing total thyroidectomy, hemithyroidectomy, and minimally invasive thermal ablation. The analysis considers both direct healthcare costs and indirect social costs, such as productivity losses, from the perspective of the Italian National Health Service.
A literature review and clinician survey were conducted to collect cost data across treatment phases: pre-hospitalization, procedure, and post-operative care. An Activity-Based Costing approach was used to estimate full treatment costs, including medical expenses, staff involvement, material usage, and indirect costs related to work absences.
The findings indicate that total thyroidectomy has the highest overall cost (€ 5,185.36), followed by hemithyroidectomy (€ 4,211.92), and thermal ablation (€ 1,560.06). The analysis also highlighted significant cost savings associated with thermal ablation when compared to surgical options, especially in terms of reduced hospital stay and lower indirect costs. Nevertheless, surgical procedures remain the mainstay treatment due to long-term efficacy and well-established clinical guidelines.
Thermal ablation represents a cost-effective alternative to surgery for managing benign thyroid nodules. Treatment selection should be individualized, considering clinical factors, patient preferences, and long-term outcomes. These results underscore the importance of updating management guidelines to incorporate economic considerations, promoting optimized care and efficient resource allocation in the healthcare context.
良性甲状腺结节在成年人中很常见，女性的偶然检出率达到50%-60%。虽然大多数结节无症状且无需治疗，但有些会生长并引起压迫症状。
本研究评估了意大利医疗体系中各种良性甲状腺结节治疗方式的经济影响，比较了全甲状腺切除术、半甲状腺切除术和微创热消融术。该分析从意大利国家医疗服务体系的角度考虑了直接医疗成本和间接社会成本，如生产力损失。
进行了文献综述和临床医生调查，以收集各治疗阶段（住院前、手术和术后护理）的成本数据。采用基于活动的成本核算方法来估算完整的治疗成本，包括医疗费用、人员参与、材料使用以及与缺勤相关的间接成本。
研究结果表明，全甲状腺切除术的总体成本最高（5185.36欧元），其次是半甲状腺切除术（4211.92欧元）和热消融术（1560.06欧元）。分析还强调，与手术选择相比，热消融术可显著节省成本，尤其是在缩短住院时间和降低间接成本方面。然而，由于长期疗效和成熟的临床指南，手术仍然是主要的治疗方法。
热消融术是治疗良性甲状腺结节的一种具有成本效益的手术替代方案。治疗选择应个体化，考虑临床因素、患者偏好和长期结果。这些结果强调了更新管理指南以纳入经济考虑因素的重要性，在医疗环境中促进优化护理和高效资源分配。
