TY - JOUR
T1 - The true cost of thyroid surgery determined by a micro-costing approach
AU - Filetti, Sebastiano
AU - Ladenson, Paul W.
AU - Biffoni, Marco
AU - D’Ambrosio, Maria Giuseppina
AU - Giacomelli, Laura
AU - Lopatriello, Stefania
N1 - Funding Information:
SL and Johns Hopkins University (for PWL) received funding from Veracyte for this project.
Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Whether the amount of the current DRG tariff for thyroid surgery covers its actual cost has been questioned. We estimated a reliable cost of thyroid surgery for a large Italian hospital. A micro-costing approach is used with data from the University Hospital “Umberto I,” a large facility that conducts a high volume of thyroidectomy surgical procedures in the Lazio region. The direct costs of surgery and hospitalization for a total and a hemi-thyroidectomy were €4956 and €4673, respectively. When compared to the DRG tariff of €3340, total thyroidectomy was €1616 (48 %) more per procedure and hemi-thyroidectomy was €1333 (40 %) more per procedure. This DRG shortfall is calculated to generate an annual procedure-specific deficit of approximately €1.38 million for this hospital. Furthermore, when the costs associated with pre-surgical work-up, post-surgical follow-up, and complications management through 12 months are incorporated, the estimated costs of total and hemi-thyroidectomy rose to €5812 and €5277, respectively. The true cost of thyroid surgery in Italy is significantly higher than what has been reported in the literature or reimbursed by the DRG tariff.
AB - Whether the amount of the current DRG tariff for thyroid surgery covers its actual cost has been questioned. We estimated a reliable cost of thyroid surgery for a large Italian hospital. A micro-costing approach is used with data from the University Hospital “Umberto I,” a large facility that conducts a high volume of thyroidectomy surgical procedures in the Lazio region. The direct costs of surgery and hospitalization for a total and a hemi-thyroidectomy were €4956 and €4673, respectively. When compared to the DRG tariff of €3340, total thyroidectomy was €1616 (48 %) more per procedure and hemi-thyroidectomy was €1333 (40 %) more per procedure. This DRG shortfall is calculated to generate an annual procedure-specific deficit of approximately €1.38 million for this hospital. Furthermore, when the costs associated with pre-surgical work-up, post-surgical follow-up, and complications management through 12 months are incorporated, the estimated costs of total and hemi-thyroidectomy rose to €5812 and €5277, respectively. The true cost of thyroid surgery in Italy is significantly higher than what has been reported in the literature or reimbursed by the DRG tariff.
KW - Costs and cost analysis
KW - Diagnosis-related groups
KW - Healthcare costs
KW - Italy
KW - Reimbursement mechanisms
KW - Thyroidectomy
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U2 - 10.1007/s12020-016-0980-z
DO - 10.1007/s12020-016-0980-z
M3 - Article
C2 - 27172916
AN - SCOPUS:84966699000
SN - 1355-008X
VL - 55
SP - 519
EP - 529
JO - Endocrine
JF - Endocrine
IS - 2
ER -