Steven Groene, MD, Davis Heniford, Tanushree Prasad, MA, Amy Lincourt, PhD, MBA, Vedra Augenstein, MD, Brent Matthews, MD. Carolinas Medical Center
Although robotic-assisted surgery is being utilized more frequently for Urologic, Gynecologic and General Surgery cases, cost continues to be somewhat prohibitive. Our aim was to compare supply utilization costs among 5 hospitals where robotic-assisted prostatectomies (RAP) are commonly performed.
Review of supply utilization cost data, procedure volume, case length and LOS from 5 hospitals within the Carolinas Healthcare System (CHS) during 2014 was performed. Descriptive statistics were used to summarize the data.
The average case volume among the 5 hospitals was 41 cases, with a range of 21 to 60 cases. The average OR time was 250 minutes, ranging from 195 to 298 minutes. The average overall supply utilization cost among the hospitals was $3037; the most expensive hospital (A) averaged $3762/case and the least expensive hospital (E) $2402/case. Overall and within each hospital, robotic disposables represented the highest supply utilization cost (44% of total averaged costs); hospital A had the lowest percentage attributed this category (31%). The second-highest supply utilization cost overall and within each hospital was trays/packs(16% total averaged costs). Individually, this amounted to16.2%, 16.8%, 11%, 13.3% and 26.6% cost utilization, respectively. Hemostatics represented the third-highest supply utilization cost (9% total average costs). Of its total supply costs, hospital A utilized 10% on electrocautery(vs. 7% averaged group utilization), 8% on clips(vs. 4%) and 15.4% on hemostatics(vs. 9%).
Within CHS, there is a wide variety in case volume, OR time and supply utilization costs among the 5 hospitals that perform RAP. The hospital that had the highest average itemized cost generally spent more on electrocautery, clips, and hemostatic agents. Each hospital had the highest percent utilization cost in robotic disposables followed by kits/trays.