Benoit R M, Cohen J K, Miller R J
Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Urology. 1998 Nov;52(5):820-4. doi: 10.1016/s0090-4295(98)00300-8.
To compare the hospital costs of radical prostatectomy (RP) and cryosurgical ablation of the prostate (CSAP).
All patients who underwent either RP or CSAP at Allegheny General Hospital during an 18-month period beginning in January 1995 were included in this study. Hospital costs were generated for each case, and a chart review was undertaken for each patient. Costs were obtained from the hospital accounting office and divided into 11 categories, including total costs. Pretreatment grade, clinical stage, and prostate-specific antigen level were obtained from the patient's chart. Noncost information such as length of stay, number of operating room units charged, and patient age were also obtained from the hospital record.
Sixty-seven men underwent RP and 114 men underwent CSAP during the study period. Average hospital costs were $4150 for men undergoing CSAP and $5660 for men undergoing RP, a difference of 27.2% (P < 0.001). The difference in hospital costs was almost completely explained by the difference in room costs ($682 for CSAP and $2348 for RP). Length of stay was 1.1 days for CSAP and 3.5 days for RP. Average operating room costs were higher for CSAP ($2309) than for RP ($ 1326).
As costs become an ever more critical factor in healthcare, the costs of various treatment options for clinically localized prostate cancer will become as important as clinical outcomes in deciding appropriate treatment. From a strictly financial perspective, CSAP is a viable treatment option for clinically localized prostate cancer.
比较根治性前列腺切除术(RP)与前列腺冷冻消融术(CSAP)的住院费用。
本研究纳入了1995年1月开始的18个月期间在阿勒格尼综合医院接受RP或CSAP治疗的所有患者。为每个病例计算住院费用,并对每位患者进行病历审查。费用从医院会计办公室获取,并分为11类,包括总费用。从患者病历中获取治疗前分级、临床分期和前列腺特异性抗原水平。住院时间、手术室收费单元数量和患者年龄等非费用信息也从医院记录中获取。
在研究期间,67名男性接受了RP,114名男性接受了CSAP。接受CSAP的男性平均住院费用为4150美元,接受RP的男性为5660美元,相差27.2%(P<0.001)。住院费用的差异几乎完全由病房费用的差异所解释(CSAP为682美元,RP为2348美元)。CSAP的住院时间为1.1天,RP为3.5天。CSAP的平均手术室费用(2309美元)高于RP(1326美元)。
随着费用在医疗保健中变得越来越关键,临床局限性前列腺癌各种治疗方案的费用在决定合适的治疗时将与临床结果同样重要。从严格的财务角度来看,CSAP是临床局限性前列腺癌的一种可行治疗选择。