Page 175 - 臺大管理論叢第33卷第1期

NTU Management Review Vol. 33 No. 1 Apr. 2023

of Health and Welfare, 2020). Although thyroidectomy is a common form of surgery, it
can incur huge medical expenses owing to postoperative complications (Li et al., 2020).
While it is well known that a higher latitude in terms of operative procedure results in
better control of thyroid diseases, it can be accompanied by more complications. The

diversification of intervention and surgical treatment methods for thyroid cancer thus have
a distinct impact on the burden of medical resources. For example, a Total Thyroidectomy
(TT) is the primary treatment method for thyroid cancer; however, this method can induce

complications such as hypoparathyroidism, laryngeal nerve injuries, and hemorrhages
(Famà, Linard, Patti, Berry, Gioffrè-Florio, Piquard, and Saint-Marc, 2013). On the
other hand, although most of the surgeons argue that non-total operations result in less
morbidity; nevertheless, patients diagnosed with differentiated thyroid cancer following
non-total thyroidectomy will have greater complications due to repeated thyroid surgery

(Erbil, Barbaros, Işsever, Borucu, Salmaslioğlu, Mete, Bozbora, and Ozarmağan, 2007).
As such, different surgical procedures could result in large differences in costs and utilities
among patients.

Thyroid diseases are common in middle-aged and older adults (Helfand and Redfern,
1998). Aside from factors related to nutrition aspects such as a lack of iodine intake,
socioeconomic changes and a stressful life may also be the causes of thyroid diseases,
which are some of the typical problems in modern society (Coscia, Taler-Verčič, Chang,
Sinn, O’Reilly, Izoré, Renko, Berger, Rappsilber, Turk, and Löwe, 2020). Owing to the

advances in diagnostic methods, the lifetime costs for patients with thyroid cancer have
become relatively low compared to those for patients with other cancers (Aschebrook-
Kilfoy, Schechter, Shih, Kaplan, Chiu, Angelos, and Grogan, 2013). However, because

of the rapid increase in the incidence of thyroid cancer, the overall cost of treating this
disease can be expected to rise substantially in Taiwan in the coming decade. According to
the American Thyroid Association (ATA), health optimization and cost reduction are two
major challenges in clinical settings. Given the limited availability of resources, reducing
the burden of caring for patients with thyroid cancer has a critical impact on society

and the economy (Aschebrook-Kilfoy et al., 2013; Kwon et al., 2018; Lubitz, Kong,
McMahon, Daniels, Chen, Economopoulos, Gazelle, and Weinstein, 2014).
The remainder of this paper is organized as follows. Section 2 describes the data,

study population and the model constructed for identifying the effects of CPs on medical

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