374 ONE YEAR UPDATED COMPARATIVE COST- ANALYSIS OF OPEN AND ROBOTIC-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2012374 ONE YEAR UPDATED COMPARATIVE COST- ANALYSIS OF OPEN AND ROBOTIC-ASSISTED RADICAL PROSTATECTOMY Jeffrey Tomaszewski, Benjamin Davies, Stephen Jackman, Ronald Hrebinko, and Joel Nelson Jeffrey TomaszewskiJeffrey Tomaszewski Pittsburgh, PA More articles by this author , Benjamin DaviesBenjamin Davies Pittsburgh, PA More articles by this author , Stephen JackmanStephen Jackman Pittsburgh, PA More articles by this author , Ronald HrebinkoRonald Hrebinko Pittsburgh, PA More articles by this author , and Joel NelsonJoel Nelson Pittsburgh, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.437AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy accounts for approximately one-half of the $1.7 billion cost of prostate cancer treatment. Utilization of robotic-assisted radical prostatectomy (RARP) has increased rapidly. The cost efficacy of RARP remains undetermined. Our objective was to perform a comparative cost-analysis of RARP and open radical prostatectomy (RRP). METHODS We retrospectively reviewed all patients undergoing RARP (n=115) or RRP (n=358) by one of four surgeons at a single institution over a 12 month period. Hospital length of stay (LOS), operative time, hospital charges, reimbursement, and direct and indirect hospital costs were analyzed and compared. Ratio of costs-to-charges (RCC) rates was applied to each charge amount to calculate costs. Detailed cost information was obtained according to charge origin. RESULTS Mean LOS between patients undergoing RARP (1.2 ± 0.6 days) and RRP (1.4 ± 0.8 days) was comparable (p>0.05). Mean OR time was 56% longer in patients undergoing RARP (258 ± 57 minutes) compared to RRP (144 ± 20 minutes). Mean total costs for RARP exceeded the total costs for RRP by 74% ($11,154 versus $8269; p<0.05). Most of the difference was due to surgical supply and operating room costs ($8458 RARP versus $4,006 RRP; p<0.05). Total nursing costs were significantly greater for RRP than for RARP ($2,307 versus $876; p<0.05). 76% of the total costs associated with robotic prostatectomy were related to the robotic technique ($2565 direct, $2201 indirect). The ancillary, cardiology, imaging, administrative, laboratory and pharmacy costs were not significantly different. The operating margin for RRP and RARP is $1324 and negative $4013, respectively. CONCLUSIONS In this single institution analysis, total actual costs associated with RARP were significantly greater than costs for RRP. Higher operating room costs account for the increased cost of RARP. To achieve cost equivalence between RARP and RRP, we would have to quadruple our current volume of RARP. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e153 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeffrey Tomaszewski Pittsburgh, PA More articles by this author Benjamin Davies Pittsburgh, PA More articles by this author Stephen Jackman Pittsburgh, PA More articles by this author Ronald Hrebinko Pittsburgh, PA More articles by this author Joel Nelson Pittsburgh, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...