Functional structure of a high resolution thyroid nodule unit. Economic impact and results of its implementation in an Endocrinology department

• Published in: Endocrinología, diabetes y nutrición. diabetes y nutrición., 2024-08, Vol.71 (7), p.290-297
• Main Authors: Bodoque Cubas, Javier, Fernández Sáez, José, Martínez Hervás, Sergio, Gil Boix, José Vicente, Salazar González, Juan José, Pallarés Gasulla, Raquel María, Miret Llauradó, Marcella, Argüelles Jiménez, Iñaki, Tofé Povedano, Santiago
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alta resolución; Biopsy, Fine-Needle - economics; Citología; Cost-Benefit Analysis; Costes; Costs; Cytology; Endocrinology - economics; Female; High resolution; Hospital Departments - economics; Humans; Male; Middle Aged; Nódulo tiroideo; Prospective Studies; Referral and Consultation - economics; Spain; Thyroid nodule; Thyroid Nodule - economics; Thyroid Nodule - pathology; Thyroid Nodule - therapy; Ultrasonography - economics
• ISSN: 2530-0180; 2530-0180
• DOI: 10.1016/j.endien.2024.04.004

The high incidence of nodular thyroid pathology has led to growing concern about the economic impact that this pathology represents on the healthcare system. There are conclusive data about the cost-effectiveness of high-resolution units for nodular thyroid pathology; however, their implementation is not homogeneous in the Endocrinology and Nutrition services of our country. The objective of the present study was to evaluate the economic impact of the implementation of the high-resolution thyroid nodule unit (HRTNU) in our center. The present work is a prospective, observational and descriptive study carried out in 1314 patients (82% women, mean age 58 years ds = 11) evaluated at the HRTNU during the period of August 2022–August 2023. Demographic data (age and sex) were analyzed, referral center and consultation type, number of total consultations and neck ultrasound performed, number of fine needle aspiration (FNAB) performed, and cytology results were analyzed. In the period from August 2022 to August 2023, a total of 1314 patients were evaluated (neck ultrasound and clinical consultation) and a total of 133 FNAB were performed, of which only 2.26% were non-diagnostic. Compared to the percentage of unsatisfactory FNAB from the previous year August 2021–July 2022 of 25%, a mean saving of 9931.43 euros was estimated. 84.47% of the patients evaluated for the first time by the HRTNU were discharged, estimating a mean saving of 133,200 euros. The implementation of a HRTNU at the Endocrinology and Nutrition departments, coordinated with primary and specialized care, is a cost-effectiveness alternative, as it reduces the number of medical consultations and is accompanied by a higher rate of diagnostic FNAB. La alta incidencia de la patología nodular tiroidea ha hecho que crezca la preocupación sobre el impacto económico que representa esta patología sobre el sistema sanitario. Existen datos concluyentes acerca del coste efectividad de las unidades de alta resolución de patología nodular tiroidea, sin embargo, su implantación no es homogénea en los servicios de Endocrinología y Nutrición de nuestro país. El objetivo del presente estudio fue evaluar el impacto económico de la puesta en marcha de la unidad de alta resolución de nódulo tiroideo (UARNT) en nuestro centro. El presente trabajo es un estudio prospectivo, observacional y descriptivo en 1314 (82% mujeres, una edad media de 58 de = 11.) evaluados en la UARNT durante el periodo de Agosto 2022–Agosto 2023.