Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-3232, USA.
Urology. 2012 Jul;80(1):126-9. doi: 10.1016/j.urology.2012.03.020. Epub 2012 May 16.
To perform a contemporary comparative cost-analysis of robotic-assisted laparoscopic radical prostatectomy (RARP) and open radical retropubic prostatectomy (RRP).
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.
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.
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.
对机器人辅助腹腔镜根治性前列腺切除术（RARP）与开放式经耻骨后根治性前列腺切除术（RRP）进行当代比较成本分析。
对在 15 个月期间由 1 家机构的 4 位外科医生中进行 RARP（n=115）或 RRP（n=358）的所有患者进行回顾性分析。分析和比较了医院住院时间（LOS）、手术时间、医院费用、报销情况以及直接和间接医院费用。
行 RARP（1.2±0.6 天）和 RRP（1.4±0.8 天）的患者的 LOS 平均值无显著差异。每个病例的手术室供应成本，RARP 几乎是 RRP 的 7 倍（$2852±$528 比$417±$59；P<.05）。2 种方法的辅助、心脏病学、影像学、行政、实验室和药房成本无显著差异。RARP 每个病例的平均总成本比 RRP 高出 62%（$14006±$1641 比$8686±$1989；P<.05）。来自所有来源的支付给医院的款项几乎相等：RRP 为$10011，RARP 为$9993。因此，RRP 的平均利润为$1325，而每个 RARP 亏损$4013。
在本单机构分析中，RARP 相关的总实际成本明显高于 RRP，这归因于机器人设备和耗材。
