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Langenbeck's Archives of Surgery

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01-09-2008 | Original Article

Cost-effectiveness of scan-directed parathyroidectomy

Authors: Radu Mihai, Mary Weisters, Michael J. Stechman, Fergus Gleeson, Greg Sadler

Published in: Langenbeck's Archives of Surgery | Issue 5/2008

Abstract

Background

Concordant parathyroid localization with sestamibi and ultrasound scans allows minimally invasive parathyroidectomy (MIP) to be performed in patients with non-familial primary hyperparathyroidism (PHPT).

Aim

To investigate the financial implications of scan-directed parathyroid surgery.

Methods

Analysis of hospital records for a cohort of consecutive unselected patients treated in a tertiary referral centre.

Results

Two hundred patients (138F:62M, age 18–91years) were operated for non-familial PHPT between Jan 2003 and Oct 2007. MIP was performed in 129 patients, with a mean operative time was 35 ± 18min. Some 75 patients were discharged the same day and the others had a total of 72 in-patient days. Bilateral neck exploration (BNE) was performed in 71 patients with negative/non-concordant scans. Mean operative time was 58 ± 25min. Only nine patients were discharged the same day and a total of 93 in-patient days were used (≈1.3days/patient). The estimated total costs incurred were £215,035 (≈290,000€). These costs would have been covered by the National Tariff (£2,170 per parathyroidectomy) but were higher than those possibly incurred if all 200 patients would have undergone BNE without any radiological investigations (£166,000 ≈ 224,100€).

Conclusion

Shorter operative time and day-case admission for MIP generate costs savings that compensate only partially for the additional costs associated with parathyroid imaging studies.

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Title: Cost-effectiveness of scan-directed parathyroidectomy
Authors: Radu Mihai
Mary Weisters
Michael J. Stechman
Fergus Gleeson
Greg Sadler
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0383-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cost-effectiveness of scan-directed parathyroidectomy

Abstract

Background

Aim

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusion

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