Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Program Number: B102
Session Name: Poster Session
Growth in Ambulatory Thyroid Surgery among Medicare Beneficiaries, 2010 to 2022
Philip Brauer, MD; David Octeau, MD; Malaak Saadah, BS; Benjamin Wajsberg, MD; Eric Lamarre, MD; Jamie Ku, MD; Mario Skugor, MD; Danielle Bottalico, MD; Natalie Silver, MD; Brandon Prendes, MD; Joseph Scharpf, MD; Cleveland ClinicObjective: In 2013 the American Thyroid Association released a statement on outpatient thyroidectomy. There is little known regarding the impact of this statement on trends in thyroidectomy among otolaryngologists. We sought to investigate current trends in outpatient thyroid surgery performed by otolaryngologists within the Medicare population.
Study Design: This is a cross-sectional analysis using the Medicare Physician/Supplier Procedure Summary (PSPS) dataset from 2010 to 2022.
Methods: The site of service for thyroid surgeries performed by otolaryngologists was derived from the PSPS database. The primary outcome was change in volume over time for site of service between ambulatory surgical center, inpatient, and hospital outpatient. The relative growth rate and linear regression were used to characterize changes over the study period.
Results: A total of 57,756 claims were submitted to Medicare for thyroid surgery by otolaryngologists between 2010 and 2022. The total proportion of outpatient thyroid surgery increased from 57.1% to 71.3% (p < 0.01) and the proportion of thyroid surgery performed at ambulatory surgery sites grew from 4.9% to 9.5% (p < 0.01) with a peak of 10.1% in 2021 (Figure). The volume of outpatient total thyroidectomy increased 16.7% while the volume of ambulatory total thyroidectomy increased 80.5%. 29.0% of the thyroid surgeries performed at ambulatory sites were total thyroidectomies, 61.5% were thyroid lobectomies, and 9.5% were completion thyroidectomies.
Conclusion: There has been a significant shift towards outpatient thyroidectomy among otolaryngologists. Although most outpatient thyroidectomies are performed in the outpatient hospital setting, the rate of total thyroidectomies performed at ambulatory sites raises questions regarding safety given the guidelines provided by the ATA.
