Cost‐Effectiveness and Efficiency of Day Surgery Versus Elective Operations in Patients With Thyroid Neoplasms: A Multicenter Retrospective Cohort Study in China

ABSTRACT Day surgery for thyroid malignancies is gaining traction globally, yet comprehensive health economic evaluations in China remain limited. This study evaluates the cost‐effectiveness and safety of thyroid day surgery versus elective inpatient operations using a large‐scale multicenter dataset. We conducted a retrospective cohort study of 2979 patients with thyroid malignancies across three tertiary academic centers in 2022. Patients were stratified into day surgery (≤ 24 h) and elective inpatient (> 24 h) groups. A generalized linear mixed model was utilized to analyze hospitalization costs, adjusting for confounders and hospital‐level random effects. The day surgery group exhibited a significantly lower complication rate (0.74% vs. 1.94%, p < 0.001) and zero unplanned readmissions. After adjustment, day surgery was associated with a 40.5% reduction in total hospitalization costs (adjusted ratio = 0.595, p < 0.001). A structural cost analysis revealed the most substantial savings in comprehensive medical service fees (ratio = 0.265) and diagnostic fees (ratio = 0.323), whereas surgical technical fees remained stable. Ambulatory thyroidectomy demonstrates superior cost‐effectiveness and operational efficiency without compromising patient safety. These findings advocate for the broader implementation of day surgery pathways to optimize healthcare resource allocation in oncology.