title: Comparative hospital cost-analysis of open and robotic-assisted radical prostatectomy.
abstract: OBJECTIVE
  To perform a contemporary comparative cost-analysis of robotic-assisted laparoscopic radical prostatectomy (RARP) and open radical retropubic prostatectomy (RRP).
  
  
  METHODS
  All patients undergoing RARP (n = 115) or RRP (n = 358) by 1 of 4 surgeons at a single institution during a 15-month period were retrospectively reviewed. The hospital length of stay (LOS), operative time, hospital charges, reimbursement, and direct and indirect hospital costs were analyzed and compared.
  
  
  RESULTS
  The mean LOS between patients undergoing RARP (1.2 ± 0.6 days) and RRP (1.4 ± 0.8 days) was not significantly different. The operating room supply costs per case were almost 7 times greater for RARP ($2852 ± $528) than for RRP ($417 ± $59; P < .05). The ancillary, cardiology, imaging, administrative, laboratory, and pharmacy costs were not significantly different between the 2 approaches. The mean total costs per case for RARP exceeded the total costs for RRP by 62% ($14 006 ± $1641 vs $8686 ± $1989; P < .05). Payment to the hospital from all sources was nearly equivalent: $10 011 for RRP and $9993 for RARP. Therefore, the average profit for each RRP was $1325 and each RARP lost $4013.
  
  
  CONCLUSIONS
  In the present single-institution analysis, the total actual costs associated with RARP were significantly greater than those for RRP and were attributable to the robotic equipment and supplies.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-3232, USA. tomaszewskijj@upmc.edu
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tomaszewski
authors.forename: Jarred C
authors.initials: JC
authors.lastname: Matchett
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Davies
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Jackman
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Hrebinko
authors.forename: Joel B
authors.initials: JB
authors.lastname: Nelson
mesh_terms: D003365:Costs and Cost Analysis; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods*; D008297:Male; D011468:Prostatectomy / Q000191:economics* / Q000379:methods*; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics*