Surgical Experience Improves Thyroidectomy Outcome

, 30 to 100 operations (group C), and more than 100 operations (group D).

After taking into consideration patient age, race, and other existing medical problems to produce a more accurate comparison, the researchers found significant differences in the four categories of surgeons. Patients whose surgeons did the most thyroid operations (group D) had the shortest length of hospital stay (1.4 days versus 1.7 days for groups B and C and 1.9 days for group A. These patients also had the lowest complication rate (5.1 percent for group D versus 6.1 for groups B and C and 8.6 for group A). In fact, the surgeon who performed the most thyroid operations among all the surgeons had the lowest complication rate (2.4 percent), shortest length of stay (1.1 days) and lowest average hospital charges ($2,990).

The superior clinical outcomes produced by greater surgical experience also translated into cost savings for thyroid cancer operations. For surgeons performing the greatest number of cancer surgeries, the average hospital charge was $3,553, versus $3,978 for group C surgeons; $4,046 for group B doctors, and $4,416 for those doctors in group A.

"In an era of ever increasing cost containment, we need to demonstrate outcome data to determine how to allocate limited resources," Udelsman says. Toby Gordon, Sc.D., a coauthor of the study and associate professor of surgery at Hopkins, says, "These kinds of outcomes studies underscore the importance of surgical experience in obtaining the best clinical results for patients and the best economic results for payers."


Contact: Gary Stephenson
Johns Hopkins Medical Institutions

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