Surgeon volume in thyroid surgery: Surgical efficiency, outcomes, and utilization

Objectives/Hypothesis To test our hypothesis that high‐surgeon volume is associated with improved surgical efficiency and 30‐day outcomes, and lower hospital utilization. Study Design Retrospective observational cohort, 2008–2013. Methods A total of 3,135 patients with hemithyroidectomy or total thyroidectomy performed by a high‐volume surgeon, propensity score‐matched to 3,135 patients with the same procedure performed by a low‐volume surgeon. All‐cause 30‐day complication, mortality, readmission, and emergency department visit rates, proportion of outpatient procedures, cut‐to‐close time, and length of stay were assessed. Results Hemithyroidectomies : Compared to low‐volume surgeons, high‐volume surgeons had fewer readmitted patients (2.7% vs. 7.0%, P < .05), more outpatient procedures (46% vs. 29%, P < .05), and shorter lengths of stay (mean [standard deviation] 16.6 [22.1] vs. 21.7 [27.5] hours, P < .05) and surgical (cut‐to‐close) times (1.7 [0.7] vs. 2.0 [1.1] hours, P < .05). Total thyroidectomies : High‐volume surgeons had lower rates of all surgery‐related complications (5.7% vs. 7.5%, P < .05), hypocalcemia (4.9% vs. 7.0%, P < .05), surgical site infections (0.3% vs. 1.0%, P < .05), more outpatient procedures (13% vs. 3%, P < .05), shorter lengths of stay (29.9 [32.8] vs. 39.8 [36.2] hours, P < .05), and cut‐to‐close times (2.4 [1.1] vs. 3.0 [1.7] hours, P < .05). Conclusion High‐volume surgeons improve patient safety and have the potential to contribute to organizational efficiency that may be underutilized in some settings. Level of Evidence 4. Laryngoscope , 126:2630–2639, 2016