Hospital volume, utilization, costs and outcomes of robot-assisted laparoscopic radical prostatectomy. Academic Article uri icon

Overview

abstract

  • PURPOSE: Although robot-assisted laparoscopic radical prostatectomy has been aggressively marketed and rapidly adopted, there is a paucity of population based utilization, outcome and cost data. High vs low volume hospitals have better outcomes for open and minimally invasive radical prostatectomy (robotic or laparoscopic) but to our knowledge volume outcomes effects for robot-assisted laparoscopic radical prostatectomy alone have not been studied. MATERIALS AND METHODS: We characterized robot-assisted laparoscopic radical prostatectomy outcome by hospital volume using the Nationwide Inpatient Sample during the last quarter of 2008. Propensity scoring methods were used to assess outcomes and costs. RESULTS: At high volume hospitals robot-assisted laparoscopic radical prostatectomy was more likely to be done on men who were white with an income in the highest quartile and age less than 50 years than at low volume hospitals (each p <0.01). Hospitals at above the 50th volume percentile were less likely to show miscellaneous medical and overall complications (p = 0.01). Low vs high volume hospitals had longer mean length of stay (1.9 vs 1.6 days) and incurred higher median costs ($12,754 vs $8,623, each p <0.01). CONCLUSIONS: Demographic differences exist in robot-assisted laparoscopic radical prostatectomy patient populations between high and low volume hospitals. Higher volume hospitals showed fewer complications and lower costs than low volume hospitals on a national basis. These findings support referral to high volume centers for robot-assisted laparoscopic radical prostatectomy to decrease complications and costs.

publication date

  • March 14, 2012

Research

keywords

  • Health Surveys
  • Hospital Costs
  • Outcome Assessment, Health Care
  • Prostatectomy
  • Robotics
  • Surgery Department, Hospital

Identity

Scopus Document Identifier

  • 84862801886

Digital Object Identifier (DOI)

  • 10.1016/j.juro.2011.12.071

PubMed ID

  • 22425094

Additional Document Info

volume

  • 187

issue

  • 5