Cost analysis of open radical cystectomy versus robot-assisted radical cystectomy
| Autor: | Anthony Koupparis, Ishna Auluck, Maisarah Amran, Sukhchain S. Bansal, Manraj Singh Sura, Tara Dogra, Peter W. Smith, Maninder Bhambra, Edward Rowe |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Operating Rooms Transfusion rate Adolescent Urology medicine.medical_treatment Operative Time 030232 urology & nephrology Cystectomy Tertiary Care Centers Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Robotic Surgical Procedures medicine Humans Blood Transfusion Operations management In patient Aged Aged 80 and over Health economics business.industry Decision Trees Health Care Costs Length of Stay Middle Aged United Kingdom Cost driver 030220 oncology & carcinogenesis Costs and Cost Analysis Cost analysis Operative time Female Quality-Adjusted Life Years business Decision tree model |
| Zdroj: | BJU International. 121:437-444 |
| ISSN: | 1464-4096 |
| Popis: | Objectives To perform a cost analysis comparing the cost of robot-assisted radical cystectomy (RARC) with open RC (ORC) in a UK tertiary referral centre and to identify the key cost drivers. Patients and Methods Data on hospital length of stay (LOS), operative time (OT), transfusion rate, and volume and complication rate were obtained from a prospectively updated institutional database for patients undergoing RARC or ORC. A cost decision tree model was created. Sensitivity analysis was performed to find key drivers of overall cost and to find breakeven points with ORC. Monte Carlo analysis was performed to quantify the variability in the dataset. Results One RARC procedure costs £12 449.87, or £12 106.12 if the robot was donated via charitable funds. In comparison, one ORC procedure costs £10 474.54. RARC is 18.9% more expensive than ORC. The key cost drivers were OT, LOS, and the number of cases performed per annum. Conclusion High ongoing equipment costs remain a large barrier to the cost of RARC falling. However, minimal improvements in patient quality of life would be required to offset this difference. |
| Databáze: | OpenAIRE |
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