title: Does the cost of robotic cholecystectomy translate to a financial burden?
abstract: BACKGROUND
  Robotic application to cholecystectomy has dramatically increased, though its impact on cost of care and reimbursement has not been elucidated. We undertook this study to evaluate and compare cost of care and reimbursement with robotic versus laparoscopic cholecystectomy.
  
  
  METHODS
  The charges and reimbursement of all robotic and laparoscopic cholecystectomies at one hospital undertaken from June 2012 to June 2013 were determined. Operative duration is defined as time into and time out of the operating room. Data are presented as median data. Comparisons were undertaken using the Mann-Whitney U-test with significance accepted at p ≤ 0.05.
  
  
  RESULTS
  Robotic cholecystectomy took longer (47 min longer) and had greater charges ($8,182.57 greater) than laparoscopic cholecystectomy (p < 0.05 for each). However, revenue, earnings before depreciation, interest, and taxes (EBDIT), and Net Income were not impacted by approach.
  
  
  CONCLUSIONS
  Relative to laparoscopic cholecystectomy, robotic cholecystectomy takes longer and has greater charges. Revenue, EBDIT, and Net Income are similar after either approach; this indicates that costs with either approach are similar. Notably, this is possible because much of hospital-based costs are determined by cost allocation and not cost accounting. Thus, the cost of longer operations and costs inherent to the robotic approach for cholecystectomy do not translate to a perceived financial burden.
authors.affiliation: Florida Hospital Tampa, 3000 Medical Park Dr. Suite 310, Tampa, FL, 33613, USA, alexander.rosemurgy@ahss.org.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rosemurgy
authors.forename: Carrie
authors.initials: C
authors.lastname: Ryan
authors.forename: Richard
authors.initials: R
authors.lastname: Klein
authors.forename: Prashant
authors.initials: P
authors.lastname: Sukharamwala
authors.forename: Thomas
authors.initials: T
authors.lastname: Wood
authors.forename: Sharona
authors.initials: S
authors.lastname: Ross
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D005431:Florida; D017721:Hospital Costs; D006801:Humans; D009873:Operating Rooms / Q000191:economics; D012371:Robotics / Q000191:economics* / Q000379:methods