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Thyroid surgeries decline after overdiagnosis controversy
  • By Song Soo-youn
  • Published 2018.12.13 11:52
  • Updated 2018.12.13 11:52
  • comments 0

Thyroid surgeries have steadily fallen in the past five years after experts raised concerns over excessive diagnosis of thyroid cancer in Korea.

The number of thyroid surgeries declined by 11 percent a year on average in the past five years to about 20,000 cases last year. Before the overdiagnosis controversy, the number used to hover around at 40,000-50,000 per year.

In stark contrast, endoscopies and percutaneous biliary surgeries increased by 7 percent annually. General spinal surgeries have raised medical costs by the most.

According to the 2017 statistics of major surgeries compiled by the National Health Insurance Service (NHIS), the number of 33 major operations rose by 1.5 percent per year on average to 1.84 million in 2017 from 1.71 million in 2012.

Among the top 15 surgeries performed the most, thyroid surgeries had the steepest drop, falling 11 percent annually on average. Hemorrhoid surgeries came next with an annual 2.8 percent decline, followed by hysterectomy with a 2.4 percent drop.

In the top-15 surgeries done most frequently, endoscopies and percutaneous biliary surgeries saw the largest growth -- increasing 7.1 percent a year on average in the past five years -- followed by cataract surgeries with 5.5 percent and stent implantations with 4.5 percent.

Last year, cataract surgeries, hemorrhoid surgeries, and cesarean sections were performed the most in Korea. There were 1,048 cataract surgeries, 617 cesarean sections, and 380 hemorrhoid surgeries per 100,000 people. While cataract surgeries have increased by an average of 5 percent per 100,000 people, cesarean sections and hemorrhoid surgeries have decreased by 2 percent and 3.2 percent, respectively.

General spinal surgeries cost the most, cataract surgeries the least

Medical costs for 33 major surgeries (except for non-reimbursed services) rose by 6.5 percent annually on average to 5.27 trillion won ($4.68 billion) in 2017 from 3.85 trillion won in 2012.

General spinal surgeries required the highest total medical costs – 607.4 billion won in 2017, followed by stent implantations with 580 billion won, and knee joint replacement surgeries with 552.1 billion won.

Cardiac surgeries were the most expensive, with 28.32 million won needed per patient. Coronary artery bypass surgery cost 27.38 million won per case, and skull base surgery, 14.57 million won.

Hemorrhoid surgery had the lowest cost with 920,000 won per case. Cataract surgery cost 970,000 won, and tonsillectomy, 1.06 million won. Cataract surgery was the most commonly performed but the most affordable.

Different age groups received different surgeries. Children under 9 underwent tonsillectomy, inguinal or femoral hernia repair, and appendectomy. Teenagers received appendectomy the most, and tonsillectomy.

People in their 20s and 30s had cesarean sections and hemorrhoid surgeries the most, and those in their 40s, hemorrhoid surgeries. From those in the 50s and onward, cataract surgeries were common. Patients in their 60s and seniors had lots of cataract surgeries, general spinal surgeries, and knee joint replacements.

64% of patients get skull base surgery in other areas

One in five surgical patients received an operation in areas other than their residential ones.

About 64 percent of patients who underwent a skull base surgery had the operation in other regions. On the contrary, 85 percent of appendectomy, 83.4 percent of hemorrhoid surgery, and 82.2 percent of cesarean sections were performed in patients’ residential areas.

By type of medical institution, hospitals and general hospitals had 0.8 percent and 0.3 percent annual increase in the number of surgeries, while tertiary hospitals and clinics had 0.1 percent and 0.6 percent decrease, in the past five years.

At tertiary hospitals, cholecystectomy was performed the most with 30,866 cases, followed by stent implantations with 30,497, and endoscopies and percutaneous biliary surgery with 29,918.

At clinics, cataract surgery and hemorrhoid surgery recorded 124,467 cases, cesarean sections, 54,732, and endoscopic sinus surgery, 24,474.


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