内分泌科高分辨率甲状腺结节诊所的经济影响和满意度

Gonzalo Díaz-Soto, Beatriz Torres, Juan Jose López Gómez, Emilia Gómez Hoyos, Aurelia Villar, Enrique Romero, Daniel A. de Luis
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引用次数: 9

摘要

背景与目的高分辨率甲状腺结节临床对结节性甲状腺疾病的治疗价值尚无定论。本研究的目的是评估与初级保健相协调的高分辨率甲状腺结节诊所(HRTNC)的经济影响和用户满意度。患者和方法进行了一项前瞻性、观察性、描述性研究,分析了2014年至2015年间在HRTNC评估的3726名患者(平均年龄61±12岁;85%为女性)的数据。评估人口统计学数据(性别和年龄)、超声检查次数和细针穿刺细胞学检查(FNAC)、转诊中心和会诊类型。结果2014年和2015年,共进行了3726次颈部超声检查和926次FNAC(3.8%被评为非诊断性)。在1227名首次接受评估的患者中,21.5%的患者不需要第二次内分泌预约,这导致平均估计节省14354.55欧元。在所有患者中,41.1%来自初级保健,33.4%来自内分泌,26.5%来自其他专业。与2013年相比,2014年和2015年要求进行甲状腺超声检查的次数分别减少了65.3%和59.7%,平均估计节省了137563.92欧元。在5分量表上,评估的平均用户满意度为4.0分(95%置信区间,3.7-4.3)。结论内分泌科的HRTNC与初级保健相协调,是一种可行的、成本效益高的替代方案,具有积极的用户感知。
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Economic impact of and satisfaction with a high resolution thyroid nodule clinic at the endocrinology department

Background and objective

No conclusive data exist on the value of a high resolution thyroid nodule clinic for management of nodular thyroid disease. The aim of this study was to evaluate the economic impact of and user satisfaction with a high resolution thyroid nodule clinic (HRTNC) in coordination with primary care.

Patients and method

A prospective, observational, descriptive study was conducted to analyze data from 3726 patients (mean age 61 ± 12 years; 85% women) evaluated at an HRTNC during 2014 and 2015. Demographic data (sex and age), number of ultrasound examinations and fine needle aspiration cytologies (FNAC), referral center and consultation type were assessed.

Results

In 2014 and 2015, 3726 neck ultrasound examinations and 926 FNACs (3.8% rated as non-diagnostic) were performed. Among the 1227 patients evaluated for the first time, 21.5% did not require a second endocrine appointment, which resulted in mean estimated savings of 14,354.55 euros. Of all patients, 41.1% were referred from primary care, 33.4% from endocrinology, and 26.5% from other specialties. As compared to 2013, the number of thyroid ultrasound examinations requested decreased by 65.3% and 59.7% in 2014 and 2015 respectively, with mean estimated savings of 137,563.92 euros. Mean user satisfaction assessed was 4.0 points (95% confidence interval, 3.7–4.3) on a 5-point scale.

Conclusions

HRTNCs at endocrinology departments, coordinated with primary care, are a viable, cost-effective alternative with a positive user perception.

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