Daycare and Inpatient Hemithyroidectomy: A Cost Minimisation and Safety Study-Hospital Kuala Lumpur Malaysia Experience

Abstract

Introduction: The duration of daycare surgery (DS) is relatively shorter compared to other types of surgeries. The main objective here is to provide comfort to the patients and family members without compromising safety and quality of medical care for the patients. In addition, there are many proven advantages of DS such as shorter waiting time, earlier return to work, reduced cross-infections, reduced cancellation rates due to emergency cases and cost-effective. Due to the constraints of inpatient operating time and availability of hospital beds, thyroid surgery is performed as DS in our centre. In this study, we analysed the cost-effectiveness and safety between the daycare and inpatient hemithyroidectomy. Methods: This cost minimisation comparative study was conducted in Kuala Lumpur Hospital, Malaysia, from January 2019 to June 2021. The total cost for each hemithyroidectomy for providers and patients were calculated for both groups. Any complications in the surgery for the two groups were documented. Result: Seventy-one patients were recruited: forty-one (57.7%) daycare hemithyroidectomies and thirty (42.3%) inpatient hemithyroidectomies. The cost of daycare hemithyroidectomy were significantly lower than the inpatient hemithyroidectomy with a median percentile of RM1089.00 (IQR= RM 339.48) and RM 1477.10 (IQR = RM 434.02) respectively (p-value <0.001). None of the patients in either group developed any surgical complications. Conclusion: Daycare hemithyroidectomy minimises the cost for providers while still maintaining the safety of the procedure. Therefore, daycare hemithyroidectomy is cost-effective and should be advocated in all tertiary hospitals in Malaysia.