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The true cost of thyroid surgery determined by a micro-costing approach

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Abstract

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.

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Funding

SL and Johns Hopkins University (for PWL) received funding from Veracyte for this project.

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Correspondence to Sebastiano Filetti.

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Conflict of interest

PWL is a consultant to Veracyte, and has received speaker honoraria from Veracyte. SF, MB, MGD, and LG declare no conflicts.

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Filetti, S., Ladenson, P.W., Biffoni, M. et al. The true cost of thyroid surgery determined by a micro-costing approach. Endocrine 55, 519–529 (2017). https://doi.org/10.1007/s12020-016-0980-z

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Keywords

  • Diagnosis-related groups
  • Healthcare costs
  • Reimbursement mechanisms
  • Thyroidectomy
  • Costs and cost analysis
  • Italy