Variation in cost of total thyroidectomy across the United States, 2007 to 2008

In the American Journal of Surgery, Caroline Reinke and colleagues, including Rachel Kelz, share their findings on state-level variation in wage-adjusted total cost (WATC) of a common surgical procedure. Using data from the Nationwide Inpatient Sample, the researchers performed a retrospective cohort study of patients undergoing a total thyroidectomy.  WATC was calculated from charges and adjusted for the area wage index. The authors find that 37% of WATC variance is due to differences across hospitals, 28% is explained by patient-level factors and 8% is due to differences across states. More than a quarter of the variation in cost is not explained by patient-, hospital- or state-level factors. The authors conclude that further research is needed to understand the unexplained variation.