Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Annual Financial Impact of Thyroidectomies for Nodular Thyroid Disease in China

  • Liu, Xiao-Yun (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Zhu, Li-Jun (Department of Children's Health Care, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University) ;
  • Cui, Dai (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Wang, Zhi-Xiao (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Chen, Huan-Huan (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Duan, Yu (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Shen, Mei-Ping (Department of Surgery, The First Affiliated Hospital of Nanjing Medical University) ;
  • Zhang, Zhi-Hong (Department of Pathology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Wang, Xiao-Dong (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Chen, Jia-Wei (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University) ;
  • Alexander, Erik Karl (Thyroid Unit, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School) ;
  • Yang, Tao (Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University)
  • Published : 2014.07.30
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Abstract

A large proportion of patients with thyroid nodules in China undergo thyroidectomy in order to get confirmatory histology diagnosis. The financial impact of this modality remains to be investigated. To evaluate rationality of performing thyroidectomy without a routine FNA preoperatively from the economic perspective, we conducted a retrospective, observational study of all archival thyroidectomies with records of cost per stay (CPS), cost per day (CPD) and length of stay (LOS) from 2008 to 2013 in the First Affiliated Hospital of Nanjing Medical University. We compared all the parameters between cancer and non-cancer thyroidectomies. We recruited 6, 140 thyroidectomies with valid records of CPS, CPD and LOS in this period. The CPS of cancer thyroidectomy was significantly higher than non-cancer thyroidectomy. The percentage of cancer thyroidectomy increased from 26.5% to 41.6%. The percentage of annual cost of cancer thyroidectomies rose from 30.2% to 45.2%. The LOS for cancer and non-cancer thyroidectomy decreased while the CPD increased in the past six years. The estimated national cost in 2012 for all thyroidectomies would be USD 1.86 billion with USD 1.09 billion for non-cancer thyroidectomies. We have witnessed great improvement in the healthcare for patients with thyroid nodules in China. However, given limited healthcare resources, currently thyroid FNA for more precise preoperative diagnosis may help to curb the rapidly increasing demand in healthcare costs in the future for nodular thyroid disease in China.

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