Cost implications of different surgical management strategies for primary hyperparathyroidism. Discussion.
Annual Meeting of the American Association of Endocrine Surgeons. Orlando, FL, USA, 1998/04/26.
Controversy exists about optimal management of patients with primary hyperparathyroidism.
To date, no studies have explored the cost implications of variation in practice.
Results from a national survey of endocrine surgeons were combined with results from a survey of endocrinologists and financial data from Medicare.
Patterns of use of resources were identified, annual costs for the surgical management of primary hyperparathyroidism in the United States were calculated, and the financial impact of variation in practice was estimated.
Survey respondents (n=109) were experienced endocrine surgeons, performing an average of 33 parathyroidectomies annually.
Seventy-five percent of patients undergo localization before initial exploration for primary hyperparathyroidism.
In order of preference, these studies were sestamibi (43%), ultrasonography (28%), and sestamibi with single-photon emission computed tomography (26%). Although there is variation in preoperative and postoperative practice, in-hospital costs have the greatest influence on total cost.
An estimated $282 million is spent annually in the United States on operations for primary hyperparathyroidism.
National health expenditures could range by more than $70 million, depending on whether management strategies involving low or high use of resourves are employed. (...)
Mots-clés Pascal : Hyperparathyroïdie, Primaire, Analyse coût, Parathyroïdectomie, Stratégie, Indication, Questionnaire, Aspect économique, Arbre décision, Homme, Etats Unis, Amérique du Nord, Amérique, Endocrinopathie, Parathyroïde pathologie, Chirurgie, Economie santé
Mots-clés Pascal anglais : Hyperparathyroidism, Primary, Cost analysis, Parathyroidectomy, Strategy, Indication, Questionnaire, Economic aspect, Decision tree, Human, United States, North America, America, Endocrinopathy, Parathyroid diseases, Surgery, Health economy
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0076615
Code Inist : 002B25L. Création : 31/05/1999.