Parathyroidectomy Rates Are Low Across VA System
Despite the benefits of surgical management of primary hyperparathyroidism, only 12.8% of patients in the US Department of Veterans Affairs (VA) health care system underwent parathyroidectomy, according to a study.
“Although there is notable variation in parathyroidectomy use for definitive treatment of primary hyperparathyroidism between VA facilities, parathyroidectomy rates are low across the entire system,” the researchers wrote.
The retrospective study focused on 47,158 veterans with primary hyperparathyroidism who received VA care between January 2000 and September 2015. The researchers were interested in the use of parathyroidectomy for primary hyperparathyroidism management within a national, integrated health care system.
In addition to identifying a 12.8% overall rate of parathyroidectomy throughout the VA system, the researchers found several variations in parathyroidectomy use among facilities. The highest complexity referral centers, for instance, had a 13.6% parathyroidectomy rate compared with a 12.1% rate across all other facilities. Facilities with higher frequency of parathyroid hormone testing for patients with hypercalcemia had a 15.2% parathyroidectomy rate compared with a 12.6% rate at facilities with lowest parathyroid hormone testing frequency.
In addition, parathyroidectomy rates were 17.0% in the Continental and 16.0% in the Pacific regions, according to the study, compared with 11.4% in other areas.
“Further research is needed to understand additional local contextual and other patient and clinician-level factors for the undertreatment of primary hyperparathyroidism to subsequently guide corrective interventions,” the researchers advised.
—Jolynn Tumolo
Reference:
Alore EA, Massarweh NN, Ramsey DJ, et al. Variation in surgical management of primary hyperparathyroidism in the US Department of Veterans Affairs healthcare system: a 15-year observational study. Surgery. 2020;168(5):838-844. https://doi.org/10.1016/j.surg.2020.05.018