title: High radical prostatectomy surgical volume is related to lower radical prostatectomy total hospital charges.
abstract: OBJECTIVE
  To test the hypothesis that individual surgical volume (SV) is an independent predictor of radical prostatectomy (RP) total charges.
  
  
  METHODS
  We used the Florida State Inpatient Data File. ICD-9 codes 60.5 (RP) and 185 (prostate cancer) identified all men treated with RP for prostate cancer between January 1 and December 31, 1998. Among 1,923,085 records, 3167 RPs were selected. SV represented the predictor. Total RP charges represented the outcome. Age, race, and comorbidity represented covariates. Univariate and multivariate linear regression models were used.
  
  
  RESULTS
  All 3167 RPs were performed by 81 surgeons. SV ranged from 2 to 162 (mean, 68). Charges were 4755 dollars to 140,201 dollars (mean, 18,200 dollars). In the multivariate model, each SV increment corresponding to one RP reduced hospital charges by 25 dollars (p < or = 0.001).
  
  
  CONCLUSIONS
  Redistribution of RPs from low to high SV users could result in significant savings. For example, 4 million dollars could be saved if 1000 RPs were redistributed from surgeons with an SV of 18 to surgeons with an SV of 200.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Ramirez
authors.forename: Serge
authors.initials: S
authors.lastname: Benayoun
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Jongi
authors.initials: J
authors.lastname: Chun
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kattan
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Michael
authors.initials: M
authors.lastname: McCormack
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017722:Hospital Charges; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data