title: Hospitalization costs for radical prostatectomy attributable to robotic surgery.
abstract: BACKGROUND
  With health technology innovation responsible for higher health care costs, it is essential to have accurate estimates regarding the differential costs between robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP).
  
  
  OBJECTIVE
  To describe the total hospitalization costs attributable to robotic and open surgery for radical prostatectomy (RP).
  
  
  METHODS
  Using a population-based cohort by merging the Nationwide Inpatient Sample (NIS) and the American Hospital Association (AHA) survey from 2006 to 2008, we identified 29 837 prostate cancer patients who underwent RP.
  
  
  METHODS
  ORP and RARP.
  
  
  METHODS
  The primary outcome was total hospitalization costs adjusted to year 2008 US dollars. Generalized estimating equations were used to identify patient and hospital characteristics associated with total hospitalization costs and to estimate costs of ORP and RARP adjusted for case mix and hospital teaching status, location, and annual case volume.
  
  
  CONCLUSIONS
  Overall, 20 424 (68.5%) patients were surgically treated with RARP, and 9413 (31.5%) patients underwent ORP. Compared to ORP, patients undergoing RARP had shorter median length of stay (1 d vs 2 d; p<0.001) and were less likely to experience any postoperative complications (8.2% vs 11.3%; p<0.001). However, patients undergoing RARP had higher median hospitalization costs ($10409 vs $8862; p<0.001). After adjusting for patient and hospital features, RARP was associated with higher total hospitalization costs compared to ORP ($11932 vs $9390; p<0.001). Our results are limited by a study design using retrospective population-based data.
  
  
  CONCLUSIONS
  Despite RARP having lower complications and shorter length of stay than ORP, total hospitalization costs are higher for patients treated with RARP compared with those treated with ORP.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA. Kim.Simon@mayo.edu
authors.forename: Simon P
authors.initials: SP
authors.lastname: Kim
authors.forename: Nilay D
authors.initials: ND
authors.lastname: Shah
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Weight
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Shippee
authors.forename: Leona C
authors.initials: LC
authors.lastname: Han
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boorjian
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
authors.forename: Igor
authors.initials: I
authors.lastname: Frank
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000628:therapy; D011468:Prostatectomy / Q000009:adverse effects / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics* / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States