Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy

Alexander P Cole; Jeffrey J Leow; Steven L Chang; Benjamin I Chung; Christian P Meyer; Adam S Kibel; Mani Menon; Paul L Nguyen; Toni K Choueiri; Gally Reznor; Stuart R Lipsitz; Jesse D Sammon; Maxine Sun; Quoc-Dien Trinh

doi:10.1016/j.juro.2016.04.087

Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy

Standard

Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy. / Cole, Alexander P; Leow, Jeffrey J; Chang, Steven L; Chung, Benjamin I; Meyer, Christian P; Kibel, Adam S; Menon, Mani; Nguyen, Paul L; Choueiri, Toni K; Reznor, Gally; Lipsitz, Stuart R; Sammon, Jesse D; Sun, Maxine; Trinh, Quoc-Dien.

in: J UROLOGY, Jahrgang 196, Nr. 4, 10.2016, S. 1090-5.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Cole, AP, Leow, JJ, Chang, SL, Chung, BI, Meyer, CP, Kibel, AS, Menon, M, Nguyen, PL, Choueiri, TK, Reznor, G, Lipsitz, SR, Sammon, JD, Sun, M & Trinh, Q-D 2016, 'Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy', J UROLOGY, Jg. 196, Nr. 4, S. 1090-5. https://doi.org/10.1016/j.juro.2016.04.087

APA

Cole, A. P., Leow, J. J., Chang, S. L., Chung, B. I., Meyer, C. P., Kibel, A. S., Menon, M., Nguyen, P. L., Choueiri, T. K., Reznor, G., Lipsitz, S. R., Sammon, J. D., Sun, M., & Trinh, Q-D. (2016). Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy. J UROLOGY, 196(4), 1090-5. https://doi.org/10.1016/j.juro.2016.04.087

Vancouver

Cole AP, Leow JJ, Chang SL, Chung BI, Meyer CP, Kibel AS et al. Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy. J UROLOGY. 2016 Okt;196(4):1090-5. https://doi.org/10.1016/j.juro.2016.04.087

Bibtex

@article{f13dce508b1b4b369f00364051271bf8,

title = "Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy",

abstract = "PURPOSE: We assessed surgeon and hospital level variation in robot-assisted radical prostatectomy costs and predictors of high and low cost surgery.MATERIALS AND METHODS: The study population consisted of a weighted sample of 291,015 men who underwent robot-assisted radical prostatectomy for prostate cancer by 667 surgeons at 197 U.S. hospitals from 2003 to 2013. We evaluated 90-day direct hospital costs (2014 USD) in the Premier Hospital Database. High costs per robot-assisted radical prostatectomy were those above the 90th percentile and low costs were those below the 10th percentile.RESULTS: Mean hospital cost per robot-assisted radical prostatectomy was $11,878 (95% CI $11,804-$11,952). Mean cost was $2,837 (95% CI $2,805-$2,869) in the low cost group vs $25,906 (95% CI $24,702-$25,490) in the high cost group. Nearly a third of the variation in robot-assisted radical prostatectomy cost was attributable to hospital characteristics and more than a fifth was attributable to surgeon characteristics (R-squared 30.43% and 21.25%, respectively). High volume surgeons and hospitals (90th percentile or greater) had decreased odds of high cost surgery (surgeons: OR 0.24, 95% CI 0.11-0.54; hospitals: OR 0.105, 95% CI 0.02-0.46). The performance of robot-assisted radical prostatectomy at a high volume hospital was associated with increased odds of low cost robot-assisted radical prostatectomy (OR 839, 95% CI 122-greater than 999).CONCLUSIONS: This study provides insight into the role of surgeons and hospitals in robot-assisted radical prostatectomy costs. Given the substantial variability, identifying and remedying the root cause of outlier costs may yield substantial benefits.",

keywords = "Journal Article",

author = "Cole, {Alexander P} and Leow, {Jeffrey J} and Chang, {Steven L} and Chung, {Benjamin I} and Meyer, {Christian P} and Kibel, {Adam S} and Mani Menon and Nguyen, {Paul L} and Choueiri, {Toni K} and Gally Reznor and Lipsitz, {Stuart R} and Sammon, {Jesse D} and Maxine Sun and Quoc-Dien Trinh",

year = "2016",

month = oct,

doi = "10.1016/j.juro.2016.04.087",

language = "English",

volume = "196",

pages = "1090--5",

journal = "J UROLOGY",

issn = "0022-5347",

publisher = "Elsevier Inc.",

number = "4",

}

RIS

TY - JOUR

T1 - Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy

AU - Cole, Alexander P

AU - Leow, Jeffrey J

AU - Chang, Steven L

AU - Chung, Benjamin I

AU - Meyer, Christian P

AU - Kibel, Adam S

AU - Menon, Mani

AU - Nguyen, Paul L

AU - Choueiri, Toni K

AU - Reznor, Gally

AU - Lipsitz, Stuart R

AU - Sammon, Jesse D

AU - Sun, Maxine

AU - Trinh, Quoc-Dien

PY - 2016/10

Y1 - 2016/10

N2 - PURPOSE: We assessed surgeon and hospital level variation in robot-assisted radical prostatectomy costs and predictors of high and low cost surgery.MATERIALS AND METHODS: The study population consisted of a weighted sample of 291,015 men who underwent robot-assisted radical prostatectomy for prostate cancer by 667 surgeons at 197 U.S. hospitals from 2003 to 2013. We evaluated 90-day direct hospital costs (2014 USD) in the Premier Hospital Database. High costs per robot-assisted radical prostatectomy were those above the 90th percentile and low costs were those below the 10th percentile.RESULTS: Mean hospital cost per robot-assisted radical prostatectomy was $11,878 (95% CI $11,804-$11,952). Mean cost was $2,837 (95% CI $2,805-$2,869) in the low cost group vs $25,906 (95% CI $24,702-$25,490) in the high cost group. Nearly a third of the variation in robot-assisted radical prostatectomy cost was attributable to hospital characteristics and more than a fifth was attributable to surgeon characteristics (R-squared 30.43% and 21.25%, respectively). High volume surgeons and hospitals (90th percentile or greater) had decreased odds of high cost surgery (surgeons: OR 0.24, 95% CI 0.11-0.54; hospitals: OR 0.105, 95% CI 0.02-0.46). The performance of robot-assisted radical prostatectomy at a high volume hospital was associated with increased odds of low cost robot-assisted radical prostatectomy (OR 839, 95% CI 122-greater than 999).CONCLUSIONS: This study provides insight into the role of surgeons and hospitals in robot-assisted radical prostatectomy costs. Given the substantial variability, identifying and remedying the root cause of outlier costs may yield substantial benefits.

AB - PURPOSE: We assessed surgeon and hospital level variation in robot-assisted radical prostatectomy costs and predictors of high and low cost surgery.MATERIALS AND METHODS: The study population consisted of a weighted sample of 291,015 men who underwent robot-assisted radical prostatectomy for prostate cancer by 667 surgeons at 197 U.S. hospitals from 2003 to 2013. We evaluated 90-day direct hospital costs (2014 USD) in the Premier Hospital Database. High costs per robot-assisted radical prostatectomy were those above the 90th percentile and low costs were those below the 10th percentile.RESULTS: Mean hospital cost per robot-assisted radical prostatectomy was $11,878 (95% CI $11,804-$11,952). Mean cost was $2,837 (95% CI $2,805-$2,869) in the low cost group vs $25,906 (95% CI $24,702-$25,490) in the high cost group. Nearly a third of the variation in robot-assisted radical prostatectomy cost was attributable to hospital characteristics and more than a fifth was attributable to surgeon characteristics (R-squared 30.43% and 21.25%, respectively). High volume surgeons and hospitals (90th percentile or greater) had decreased odds of high cost surgery (surgeons: OR 0.24, 95% CI 0.11-0.54; hospitals: OR 0.105, 95% CI 0.02-0.46). The performance of robot-assisted radical prostatectomy at a high volume hospital was associated with increased odds of low cost robot-assisted radical prostatectomy (OR 839, 95% CI 122-greater than 999).CONCLUSIONS: This study provides insight into the role of surgeons and hospitals in robot-assisted radical prostatectomy costs. Given the substantial variability, identifying and remedying the root cause of outlier costs may yield substantial benefits.

KW - Journal Article

U2 - 10.1016/j.juro.2016.04.087

DO - 10.1016/j.juro.2016.04.087

M3 - SCORING: Journal article

C2 - 27157376

VL - 196

SP - 1090

EP - 1095

JO - J UROLOGY

JF - J UROLOGY

SN - 0022-5347

IS - 4

ER -