Comparison of inpatient and outpatient thyroidectomy: Demographic and economic disparities.

BACKGROUND: Thyroidectomy is increasingly being performed as an outpatient procedure. In this study, we aim to examine patient characteristics and clinical factors associated with outpatient thyroid surgeries as compared to inpatient procedures.

METHODS: A cross-sectional study for the period of 2007-2010. Inpatients and outpatients were selected from the Nationwide Inpatient Sample and State Ambulatory Surgery and Services Databases, respectively. All patients were adults (≥18 years) who underwent thyroidectomy in the States of Florida and New York.

RESULTS: A total of 25,267 outpatients, and 8219 inpatients were included. Outpatients were more likely to be female, White, have private insurance, and have one or no comorbidities (p < 0.001 each). Thyroid surgeries performed for thyroid conditions other than malignancy were more common in the outpatient settings (p < 0.05 each). High-volume surgeons were more likely to perform ambulatory thyroidectomy (p < 0.001). Post-outpatient thyroidectomy complications were higher for lower volume surgeons (p < 0.001). Moreover, hospital charges for outpatient surgeries performed by lower volume surgeons were significantly higher compared to high-volume surgeons (p < 0.001).

CONCLUSIONS: Racial and economic disparities exist in the utilization of ambulatory thyroidectomy. Experienced surgeons are more likely to provide ambulatory thyroidectomy, and surgeries performed by them are associated with more favorable outcomes and lower hospital charges.