Wide Variation Noted in Total, Partial Thyroidectomy Rates by US Region

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Researchers attribute this variation to "widely divergent local beliefs and practice patterns" related to thyroid nodules and cancer care.
Researchers attribute this variation to "widely divergent local beliefs and practice patterns" related to thyroid nodules and cancer care.

HealthDay News — There is wide variation in thyroidectomy rates among Medicare beneficiaries nationally, suggesting widely divergent local practice patterns for the management of thyroid nodules and cancer, according to a study published online in JAMA Otolaryngology – Head & Neck Surgery.

David O. Francis, MD, from the University of Wisconsin, Madison, and colleagues conducted a cross-sectional analysis of Medicare data for 15,888 beneficiaries aged 65 years or older from 2014 in order to determine overall and hospital referral region-specific thyroidectomy rates.

The researchers found that in 2014, 15,888 thyroidectomies were performed (7506 partial and 8382 total) on Medicare beneficiaries, representing a national average rate of 60 per 100,000 beneficiaries. There was a 6.2-fold difference in thyroidectomy rates across US regions (range, 22 to 139 per 100,000 Medicare beneficiaries). The researchers noted that this variation is greater than that of prostatectomy rates, which are usually thought to have the widest variation in the United States.

"This wide variation in thyroidectomy rates observed among Medicare beneficiaries suggests widely divergent local beliefs and practice patterns surrounding the management of thyroid nodules and cancer because rates appeared to be unrelated to health care availability, regional socioeconomic status, or surgeons per capita. A better understanding for the reasons underlying this variation is needed," conclude the authors.

Reference

Francis DO, Randolph G, Davies L. Nationwide variation rates of thyroidectomy among US Medicare beneficiaries [published online October 12, 2017] JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2017.1746

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