Introduction: Parathyroidectomy is the only curative therapy for hyperparathyroidism, but its cost and variation in use among different racial and ethnic groups are largely unexamined. The purpose of this study was to examine the association between race and ethnicity and the total hospital cost of parathyroidectomy.
Methods: This retrospective study included 899 consecutive complete parathyroidectomies in our institution between September 2011 and July 2016. We evaluated demographics, insurance type, and readmission rates. Total length of stay and cost were primary outcomes. Categorical variables were evaluated with chi-square.
Results: The study population was 66.4% Caucasian, 31.4% African-American, 0.7% Hispanic, and 0.3% Asian. Median age was 60 years, 76% were female, and 83% were outpatients. Total hospital costs were greater for African-American patients ($5,025.22 ± 6,535.38, P = 0.013) compared to Caucasian patients ($4,787.49 ± $2,241.50). Mean length of stay was 0.99 ± 3.14 for African-American patients and 0.44 ± 1.28 for Caucasian patients (P <0.001). African-American patients were more likely than Caucasians to be readmitted (4.6% vs. 1.2%, P = 0.001). Among African Americans, males had a more expensive hospital cost (trending P = 0.072), higher incidence of cases that cost greater than $10,000 (P = 0.005), and longer length of stay (P < 0.001) compared to females.
Conclusions: African-American race was associated with higher hospital costs for parathyroidectomy compared to Caucasian patients. The increased cost could be explained in part by longer length of stay. More detailed efforts are needed to reduce racial disparity in the management of parathyroidectomy patients
