دورية أكاديمية
أعرض في EDS

One-year healthcare costs after robotic-assisted and laparoscopic partial and radical nephrectomy: a cohort study.

التفاصيل البيبلوغرافية
العنوان: One-year healthcare costs after robotic-assisted and laparoscopic partial and radical nephrectomy: a cohort study.
المؤلفون: Okhawere KE; Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6Th Floor, New York City, NY, 10029, USA. kennedy.okhawere@mountsinai.org., Milky G; Intuitive Surgical, Inc, Sunnyvale, CA, USA., Razdan S; Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6Th Floor, New York City, NY, 10029, USA., Shih IF; Intuitive Surgical, Inc, Sunnyvale, CA, USA., Li Y; Intuitive Surgical, Inc, Sunnyvale, CA, USA., Zuluaga L; Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6Th Floor, New York City, NY, 10029, USA., Badani KK; Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6Th Floor, New York City, NY, 10029, USA.
المصدر: BMC health services research [BMC Health Serv Res] 2023 Oct 14; Vol. 23 (1), pp. 1099. Date of Electronic Publication: 2023 Oct 14.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Robotic Surgical Procedures* , Kidney Neoplasms*/surgery , Laparoscopy*, Humans ; Cohort Studies ; Aftercare ; Patient Discharge ; Nephrectomy ; Health Care Costs ; Retrospective Studies ; Treatment Outcome
مستخلص: Objective: Despite the wide-spread adoption of robotic-assisted surgery (RAS), the cost-benefit implications for partial (PN) and radical nephrectomy (RN) versus laparoscopic surgery (Lap) is not well established. We sought to examine the trend of adoption and 1-year healthcare expenditure of PN and RN, and compare 1-year expenditures of RAS versus Lap for PN and RN.
Patients and Methods: This cohort study used the Merative TM MarketScan® Databases between 2013 and 2020. A total of 5,353 patients with kidney cancer undergoing PN (2,980, 55.7%) or RN (2,373, 44.3%). We compared open-conversion, length of stay (LOS), index expenditure, 1-year healthcare expenditure and utilization, and missed work-days between RAS and Lap for PN and RN.
Results: Adoption of PN increased overtime (47.0% to 55.8%), mainly driven by robotic PN increase. Among PN, RAS had lower open-conversion, shorter LOS and lower index expenditure than Lap. Among RN, RAS had shorter LOS, and similar open-conversion and index expenditures. During 1-year post-discharge, RAS had lower hospital outpatient visits (IRR = 0.92, 95% CI = 0.85, 0.99, p = 0.029) and office-based visits (IRR = 0.91, 95% CI = 0.86, 0.96, p = 0.002) for PN, translating to a 1-day less (95% CI = 0.25, 1.75, p = 0.008) missed from work for RAS. Following RN, RAS had lower 1-year readmission than Lap (O.R = 0.72, 95% CI = 0.55, 0.94, p = 0.018). RAS and Lap had comparable 1-year post-discharge expenditures for both PN (mean difference, MD = -$475, 95% CI = -$4362, $3412, p = 0.810) and RN (MD = -$4,204, 95% CI = -$13,837, $5430, p = 0.404).
Conclusion: At index surgery, RAS was associated with shorter LOS for both PN and RN, and lower open-conversion and expenditures for PN. RAS and Lap had comparable 1-year total expenditures, despite lower healthcare visits for RAS.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
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فهرسة مساهمة: Keywords: Costs; Expenditures; Kidney cancer; Laparoscopic; Nephrectomy; Robotic
تواريخ الأحداث: Date Created: 20231014 Date Completed: 20231023 Latest Revision: 20231120
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10576279
DOI: 10.1186/s12913-023-10111-8
PMID: 37838666
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6963
DOI:10.1186/s12913-023-10111-8