Socioeconomic disparities in a population of patients undergoing total thyroidectomy for benign disease

Head Neck. 2019 Mar;41(3):715-721. doi: 10.1002/hed.25421. Epub 2018 Dec 6.

Abstract

Background: This study examines the effect of insurance status (as a measure of socioeconomic status) on patient with benign thyroid disease.

Methods: A retrospective review was performed among 60 patients undergoing total thyroidectomy for benign thyroid disease. Univariate and multivariable analyses examined the relationship between insurance status and thyroid volume (sum of the left and right lobe volumes).

Results: Twenty-eight (47%) patients were considered of underinsured/uninsured status, and 32 (53%) patients were considered of private/government/military insurance status. Median pathologic whole thyroid volume was 66 mL (range, 2-855). After multivariable linear regression, underinsured/uninsured status was the only significant predictor of larger volume (correlation coefficient [r] = 118; 95% CI, 42 to 194; P = .003), after adjusting for age, sex, body mass index, and presence of concomitant thyroid disease and compressive symptoms.

Conclusion: Patients of underinsured/uninsured status suffered more severe disease presentations at time of thyroidectomy, as measured by larger thyroid volumes.

Keywords: goiter; health insurance; socioeconomic disparities; thyroid disease; thyroid volume.