Variation in prostate surgery costs and outcomes in the USA: robot-assisted versus open radical prostatectomy. (8th January 2019)

• Record Type: Journal Article
• Authors: Mukherjee, Kumar; Kamal, Khalid M
• Is Part Of: Journal of comparative effectiveness research. Volume 8:Number 3(2019)
• Page Start: 143
• Page End: 155
• Publication Date: 2019-01-08
• Subjects: comparative effectiveness -- cost disparity -- costs -- length of stay -- National Inpatient Sample -- open radical prostatectomy -- operative outcomes -- prostate cancer -- robot-assisted prostatectomy -- treatment cost; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer-2018-0109
• Languages: English
• ISSNs: 2042-6305

Abstract

Aim: To compare perioperative complications, inpatient cost and length of stay between robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP) using National Inpatient Sample data from 2010 to 2015.Patients & methods: A total of 69, 009 records with RARP or ORP were analyzed using multivariate logistic regression and generalized linear models.Results: The RARP had superior perioperative outcomes at a higher cost (adjusted mean difference = 2956; 95% CI: $2822–$3090) and shorter length of stay (mean difference = 0.85; 95% CI: 0.81–0.89) compared with ORP. Mean cost of RARP was lowest in urban teaching, private invest-own, high volume and northeast region hospitals and highest for black men.Conclusion : Compared with ORP, RARP had significantly better perioperative outcomes at a higher cost.