Wide variation in cost of surgical care for parathyroidectomy: is there a need for standardization of practice?

Academic Article

Abstract

  • Background: Identifying hospital and provider variation in surgical cost is a potent method for controlling rising healthcare expenditure and delivering cost-effective care. The purpose of this study was to examine the variation of hospital cost by providers for parathyroidectomy in a single academic institution. Methods: We retrospectively evaluated 894 consecutive parathyroidectomies under 8 surgeons in our institution between September 2011 and July 2016. Total duration of stay and cost were evaluated using nonparametric tests. Categorical variables were evaluated with χ2. Results: The median total hospital cost for parathyroidectomy was $4,863.28 (interquartile range: 4,196–5,764), but the median costs per provider varied widely from $4,522.30 to $12,072.87. The median duration of stay was 0 days (IQR: 0–1) and demonstrated a wide variation among providers. Longer duration of practice was associated with lower cost. Despite the variation, only 2% was readmitted after discharge with no patient mortality. Conclusion: We found substantial variation in hospital cost among providers for parathyroidectomy despite practicing in the same academic institution, with some surgeons spending 4 time more for the same operation. Implementing institutional standards of practice could be a method to decrease variation and costs of surgical care.
  • Published In

  • Surgery  Journal
  • Digital Object Identifier (doi)

    Author List

  • Jang S; Mandabach M; Aburjania Z; Balentine CJ; Chen H
  • Start Page

  • 638
  • End Page

  • 642
  • Volume

  • 163
  • Issue

  • 3