caa a22 4500 445336382 CHVBK 20180317142757.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1586-6 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1586-6 Strategic Impact of a New Academic Endocrine Surgery Program [Elektronische Daten] [James Wiseman, Philip Ituarte, Roy Hwang, Ilan Safir, Jesse Pasternak, Karen Van Nuys, Michael Yeh] Background: A minority of medical centers possess a dedicated endocrine surgery program. Here we assess the short-term impact of a new endocrine surgery program on institutional case volumes and financial endpoints. Methods: We studied all endocrine procedures performed over a 5-year period spanning the inception of the endocrine surgery program at UCLA. Institutional and state-level data on patient geographic origin, discharges for endocrine diagnosis-related groups (DRGs), and hospital-side charges and costs were examined. Results: Total endocrine case volume increased 112% (264 to 559 cases annually) over the study period. The relative increase was greater for parathyroid (56 to 196, 250%, P < 0.0001) and adrenal (11 to 31, 181%, P=0.06) procedures compared to thyroid procedures (317 to 442, 39%). The endocrine case volume of nonspecialist surgeons remained stable over the study period. Growth in referrals arose from previously unrepresented zip codes and was associated with an increase in the mean distance traveled for care (2006, 44 miles vs. 2009, 92 miles, P<0.01). In each DRG, UCLA attained the top market position within one year of the program's inception, corresponding to an overall 27% increase in regional market share. Total hospital charges for endocrine DRGs rose 161% to $14.7 million annually, while the cost of parathyroid surgery fell 34% (P<0.001). Conclusions: The establishment of an academic endocrine surgery program can cause fundamental shifts in referral patterns within a competitive, densely populated metropolitan environment. Hospitals should consider the inclusion of an endocrine surgery program in strategic planning initiatives. The Author(s), 2011 Wiseman James Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut Ituarte Philip Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut Hwang Roy Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA aut Safir Ilan Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut Pasternak Jesse Department of Surgery, McMaster University, Hamilton, Ontario, Canada aut Van Nuys Karen Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut Yeh Michael Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2260-2264 1068-9265 18:8<2260 2011 18 10434 https://doi.org/10.1245/s10434-011-1586-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1586-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wiseman James Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Ituarte Philip Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Hwang Roy Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Safir Ilan Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Pasternak Jesse Department of Surgery, McMaster University, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Van Nuys Karen Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Yeh Michael Endocrine Surgical Unit, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2260-2264 1068-9265 18:8<2260 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer