Wide variation in cost of surgical care for parathyroidectomy: is there a need for standardization of practice?

Samuel Jang, Meagan Mandabach, Zviadi Aburjania, Courtney J. Balentine, Herbert Chen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Identifying hospital and provider variation in surgical cost is a potent method for controlling rising healthcare expenditure and delivering cost-effective care. The purpose of this study was to examine the variation of hospital cost by providers for parathyroidectomy in a single academic institution. Methods: We retrospectively evaluated 894 consecutive parathyroidectomies under 8 surgeons in our institution between September 2011 and July 2016. Total duration of stay and cost were evaluated using nonparametric tests. Categorical variables were evaluated with χ2. Results: The median total hospital cost for parathyroidectomy was $4,863.28 (interquartile range: 4,196–5,764), but the median costs per provider varied widely from $4,522.30 to $12,072.87. The median duration of stay was 0 days (IQR: 0–1) and demonstrated a wide variation among providers. Longer duration of practice was associated with lower cost. Despite the variation, only 2% was readmitted after discharge with no patient mortality. Conclusion: We found substantial variation in hospital cost among providers for parathyroidectomy despite practicing in the same academic institution, with some surgeons spending 4 time more for the same operation. Implementing institutional standards of practice could be a method to decrease variation and costs of surgical care.

Original languageEnglish (US)
Pages (from-to)638-642
Number of pages5
JournalSurgery (United States)
Issue number3
StatePublished - Mar 2018
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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