Sharona Ross, MD, Richard Klein, Carrie Ryan, MS, Paul Toomey, MD, Prashant Sukharamwala, MD, Alexander Rosemurgy, MD. Florida Hospital Tampa; Tampa, Florida.
Introduction: Robotic application to cholecystectomy has dramatically increased, though its impact on cost of care and reimbursement has not been studied. We undertook this study to evaluate and compare cost of care and reimbursement with robotic versus laparoscopic cholecystectomy.
Methods and Procedures: 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 (mean ± SD). Comparisons were undertaken using the Mann-Whitney U-test with significance accepted at p ≤ 0.05.
Results: Robotic cholecystectomy took longer (53 minutes longer) and had greater charges ($8,182.57 greater) than laparoscopic cholecystectomy (p<0.05 for each, Table). However, revenue, earnings before depreciation, interest, and taxes (EBDIT), and net income were not impacted by approach (Table).
Conclusions: Relative to laparoscopic cholecystectomy, robotic cholecystectomy takes longer and has greater charges. Revenue, EBDIT, and net income are similar after either approach, denoting costs with either approach are determined to be similar. Notably, this is possible because much of hospital-based cost allocation is not based upon 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.
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