MP13-04 HOLMIUM LASER ENUCLEATION OF THE PROSTATE VERSUS SIMPLE PROSTATECTOMY: A COST ANALYSIS AND COMPARISON OF PRACTICE TRENDS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP13-04 HOLMIUM LASER ENUCLEATION OF THE PROSTATE VERSUS SIMPLE PROSTATECTOMY: A COST ANALYSIS AND COMPARISON OF PRACTICE TRENDS Matthew Beamer, Valmic Patel, Thomas Sanford, and Scott Wiener Matthew BeamerMatthew Beamer More articles by this author , Valmic PatelValmic Patel More articles by this author , Thomas SanfordThomas Sanford More articles by this author , and Scott WienerScott Wiener More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium Laser Enucleation of the Prostate (HoLEP) and Simple Prostatectomy (SP) are both surgical options for the treatment of large gland BPH. While multiple manuscripts compare the two procedures, there is limited data analyzing costs. Here we present current practice trends and a cost comparison between these procedures on a national level. METHODS: The Healthcare Cost and Utilization Project National Inpatient Sample and Nationwide Ambulatory Surgery Sample databases from the year 2018 were queried. CPT codes and ICD-10PCS codes were used to identify patients undergoing HoLEP or SP. Data was examined to compare practice settings, total cost, and payer information. Categorical data was compared with Chi-squared test. Cost data was nonparametric and compared with Mann-Whitney U. A linear regression analysis was performed to determine factors associated with cost. SPSS version 28 was used for all statistical analysis. RESULTS: More HoLEPs (5,782) were performed than SP (973). Most were performed at teaching institutions (HoLEP-76.7%; SP-80.0%). Medicare was the primary payer for both procedures (HoLEP-66.3%; SP-64.3%). Most HoLEP procedures were completed in the outpatient setting (87.8%) while most SPs were performed in the inpatient setting (94.3%, p<0.001). Median length of stay was longer for SP (HoLEP - 0, IQR 0; SP-3, IQR 2-4, p<0.001). The median cost for HoLEP was $26,689 (IQR: $19,292-$35,491) and SP was $51,250 (IQR: $34,683-$82,979; p<0.001). On linear regression analysis surgical type was an independent predictor of cost and HoLEP accounted for a $16,464 cost savings. Payer type was not a significant predictor of cost. HoLEPs were least commonly performed in the West (3.2%). HoLEPs were most expensive in the west ($43,960, p<0.001) and had a significantly longer hospital stay (2, p<0.001) CONCLUSIONS: HoLEP was performed more frequently and was significantly less expensive than SP. Surgery type was an independent predictor of total cost. A regional analysis suggests that HoLEPs performed at low volume centers may be more costly and result in longer hospital stays. HoLEP should be considered a cost-effective alternative to SP and referral to high volume centers may be considered. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e174 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Beamer More articles by this author Valmic Patel More articles by this author Thomas Sanford More articles by this author Scott Wiener More articles by this author Expand All Advertisement PDF downloadLoading ...