Abstract
INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost.
MATERIAL AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference in Danish kroner between total abdominal hysterectomy and robotic-assisted laparoscopic hysterectomy.
RESULTS: The average cost of consumables was 12,642 Danish kroner more expensive per patient for robotic-assisted laparoscopic hysterectomy than for total abdominal hysterectomy (2014 price level: 1€ = 7.50 Danish kroner). When including all cost-drivers, the analysis showed that the robotic-assisted laparoscopic hysterectomy procedure was 9386 Danish kroner (17%) cheaper than the total abdominal hysterectomy (p = 0.003). When the robot investment was included, the cost difference reduced to 4053 Danish kroner (robotic-assisted laparoscopic hysterectomy was 7% cheaper than total abdominal hysterectomy) (p = 0.20). Increasing age and Type 2 diabetes appeared to influence the overall costs.
CONCLUSION: For women with endometrial cancer or atypical complex hyperplasia, robotic-assisted laparoscopic hysterectomy was cheaper than total abdominal hysterectomy, mostly due to fewer complications and shorter length of hospital stay.
| Original language | English |
|---|---|
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Volume | 95 |
| Issue number | 3 |
| Pages (from-to) | 299-308 |
| Number of pages | 10 |
| ISSN | 0001-6349 |
| DOIs | |
| Publication status | Published - 1 Mar 2016 |
Keywords
- Abdomen
- Age Factors
- Aged
- Aged, 80 and over
- Anesthesia
- Denmark
- Diabetes Mellitus, Type 2
- Direct Service Costs
- Disposable Equipment
- Endometrial Hyperplasia
- Endometrial Neoplasms
- Equipment and Supplies, Hospital
- Female
- Health Resources
- Hospital Costs
- Humans
- Hysterectomy
- Length of Stay
- Middle Aged
- Operative Time
- Patient Readmission
- Personnel, Hospital
- Postoperative Complications
- Recovery Room
- Robotic Surgical Procedures
- Salaries and Fringe Benefits
- Comparative Study
- Journal Article
