Journal article
Gustavo Romero‐Velez, S. Noureldine, Talia Burneikis, A. Siperstein
Surgery, 2023
Surgery, 2023
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APA
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Romero‐Velez, G., Noureldine, S., Burneikis, T., & Siperstein, A. (2023). High-volume endocrine surgeons perform thyroid surgery at decreased cost despite increased case relative value units. Surgery.
Chicago/Turabian
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Romero‐Velez, Gustavo, S. Noureldine, Talia Burneikis, and A. Siperstein. “High-Volume Endocrine Surgeons Perform Thyroid Surgery at Decreased Cost despite Increased Case Relative Value Units.” Surgery (2023).
MLA
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Romero‐Velez, Gustavo, et al. “High-Volume Endocrine Surgeons Perform Thyroid Surgery at Decreased Cost despite Increased Case Relative Value Units.” Surgery, 2023.
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@article{gustavo2023a,
title = {High-volume endocrine surgeons perform thyroid surgery at decreased cost despite increased case relative value units.},
year = {2023},
journal = {Surgery},
author = {Romero‐Velez, Gustavo and Noureldine, S. and Burneikis, Talia and Siperstein, A.}
}
Abstract
BACKGROUND Healthcare systems are transitioning to value-based payment models based on analysis of quality over cost. To gain an understanding of the relationship between surgeon volume and health care costs, we compared the direct costs of thyroidectomy performed by dedicated high-volume endocrine surgeons and low-volume surgeons within a large health care system.
METHODS We evaluated all thyroid surgeries performed within a single billing year at a single health care system. We defined high-volume surgeons as those who treated >50 thyroid cases yearly and compared them to low-volume surgeons. To account for multicomponent procedures, we added the relative value units for the components of the cases. Then, we divided them into low-relative value units, intermediate-relative value units, and high-relative value units groups. We analyzed categorical and continuous variables using the χ2 analysis and Wilcoxon rank sum test, respectively.
RESULTS We identified 674 thyroidectomy procedures performed by 27 surgeons, of whom 6 high-volume surgeons performed 79% of cases. Relative value unit distribution differed between the groups, with high-volume surgeons performing more intermediate-relative value unit (58% vs 34.7%, P < .01) and high-relative value unit (24.6% vs 20.6%, P < .01) cases, whereas low-volume surgeons performed more low-relative value unit cases (45% vs 17%, P < .01). Overall, high-volume surgeons incurred a 26% reduction in total costs (P < .01) and a 33% reduction in discretionary expenses (P < .01) across all relative value unit groups.
CONCLUSION High-volume endocrine surgeons perform thyroid procedures at a lower cost than their low-volume counterparts, a difference that is magnified when stratified by relative value unit groups.