ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2026
Communication of Cost in Thyroidectomy: A Mixed-Methods Analysis of Financial Toxicity.
Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectiveTo assess cost information provided to patients undergoing thyroidectomy. STUDY
designExplanatory sequential mixed-methods study.
settingSingle academic medical center.
methodsAdults who underwent thyroidectomy between 1/2021 and 1/2024 completed a survey about financial toxicity. Purposive sampling identified survey respondents for semi-structured interviews to explore experiences related to cost communication. Qualitative data were thematically analyzed.
resultsOf 167 survey respondents, most were female (77.8%), white (83.8%), and underwent total thyroidectomy (65.3%). Nearly one-third experienced moderate to severe financial toxicity. Forty-one percent felt "not at all" informed about costs, while 20% sought preoperative cost information, most commonly from insurers (82.4%). Education was significantly associated with feeling cost-informed, while lowest- and highest-income, younger, and female patients trended toward greater cost-seeking behavior. Thirty-five respondents were invited for an interview; 20 consented. Almost all participants recalled no cost discussion with their care team. Several felt like they "had to" have surgery, regardless of cost, and many were surprised by copays, missed work, and medication costs. Some wished they had received estimates or information about financial resources. Participants identified insurers as a source for cost information but received vague communication regarding coverage. A few stated that while better cost information would not have changed their treatment decision, it would have better prepared them for the financial impact.
conclusionPatients undergoing thyroidectomy appear to be insufficiently informed of costs before surgery. Improved cost communication by care teams and hospital systems could improve preparedness and mitigate financial toxicity, as reliance on insurers alone appears inadequate.
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