Understanding readmissions following operations of the thyroid and parathyroid glands

BackgroundIn anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions.MethodsPatients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Primary outcome was readmission within 90 days. Univariate and multivariable logistic regression were used to determine factors associated with readmission. Subset analysis was performed for thyroid cancer patients.ResultsAmong 59,427 patients, 34.2% had thyroid cancer. Eleven percent (n = 6462) were readmitted within 90 days, with 27% readmitted to a different hospital than the index. 66.2% of thyroid cancer patients were readmitted for a related condition.ConclusionEleven percent of patients are admitted to the hospital within 90 days of an operation in the thyroid or parathyroid glands. Patient factors and diseases necessitate the use of hospital services. Bundled payments must consider the patients' needs for hospital-based services in calculating costs for surgically treated endocrine disorders.