Regional differences in total hospital costs for radical cystectomy in the United States

Benedikt Hoeh; Rocco Simone Flammia; Lukas Hohenhorst; Gabriele Sorce; Francesco Chierigo; Andrea Panunzio; Zhe Tian; Fred Saad; Michele Gallucci; Alberto Briganti; Carlo Terrone; Shahrokh F Shariat; Markus Graefen; Derya Tilki; Alessandro Antonelli; Luis A Kluth; Andreas Becker; Felix K H Chun; Pierre I Karakiewicz

doi:10.1016/j.suronc.2023.101924

Regional differences in total hospital costs for radical cystectomy in the United States

Standard

Regional differences in total hospital costs for radical cystectomy in the United States. / Hoeh, Benedikt; Flammia, Rocco Simone; Hohenhorst, Lukas; Sorce, Gabriele; Chierigo, Francesco; Panunzio, Andrea; Tian, Zhe; Saad, Fred; Gallucci, Michele; Briganti, Alberto; Terrone, Carlo; Shariat, Shahrokh F; Graefen, Markus; Tilki, Derya; Antonelli, Alessandro; Kluth, Luis A; Becker, Andreas; Chun, Felix K H; Karakiewicz, Pierre I.

In: SURG ONCOL, Vol. 48, 06.2023, p. 101924.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hoeh, B, Flammia, RS, Hohenhorst, L, Sorce, G, Chierigo, F, Panunzio, A, Tian, Z, Saad, F, Gallucci, M, Briganti, A, Terrone, C, Shariat, SF, Graefen, M, Tilki, D, Antonelli, A, Kluth, LA, Becker, A, Chun, FKH & Karakiewicz, PI 2023, 'Regional differences in total hospital costs for radical cystectomy in the United States', SURG ONCOL, vol. 48, pp. 101924. https://doi.org/10.1016/j.suronc.2023.101924

APA

Hoeh, B., Flammia, R. S., Hohenhorst, L., Sorce, G., Chierigo, F., Panunzio, A., Tian, Z., Saad, F., Gallucci, M., Briganti, A., Terrone, C., Shariat, S. F., Graefen, M., Tilki, D., Antonelli, A., Kluth, L. A., Becker, A., Chun, F. K. H., & Karakiewicz, P. I. (2023). Regional differences in total hospital costs for radical cystectomy in the United States. SURG ONCOL, 48, 101924. https://doi.org/10.1016/j.suronc.2023.101924

Vancouver

Hoeh B, Flammia RS, Hohenhorst L, Sorce G, Chierigo F, Panunzio A et al. Regional differences in total hospital costs for radical cystectomy in the United States. SURG ONCOL. 2023 Jun;48:101924. https://doi.org/10.1016/j.suronc.2023.101924

Bibtex

@article{69bff1a0d5974f66943010668ac044fe,

title = "Regional differences in total hospital costs for radical cystectomy in the United States",

abstract = "OBJECTIVES: To test for regional differences in total hospital costs (THC) across the United States in bladder cancer patients treated with open radical cystectomy (ORC) or robotic-assisted radical cystectomy (RARC).MATERIALS: We relied on the National Inpatient Sample (NIS) database (2016-2019) and stratified RC patients according to census region (Midwest, Northeast, South, West). Primary statistical analyses consisted of THC-trend analyses and multivariable log-link linear regression models, after adjustment for hospital clustering (Generalized Estimating Equation function) and discharge disposition weighting. Finally, sensitivity analysis, relying on most favorable patient cohort, was performed.RESULTS: Of 5280 eligible patients, 1441 (27%), 1031 (20%), 1854 (35%) and 954 (18%) underwent RC in the Midwest, Northeast, South and West, respectively. Median THC was 28,915$ and differed significantly between regions (Midwest: 28,105$; Northeast: 28,886$; South: 26,096$; West: 38,809$; p < 0.001). After stratification between ORC and RARC, highest THC was invariably recorded in the West: ORC 36,137$ vs 23,941-28,850$ and RARC 43,119$ vs 28,425-29,952$ (both p < 0.05). In multivariable log-link linear regression models, surgery in the West was independently associated with higher THC: ORC (Exponent beta [Exp[β]]: 1.39; 95%-CI: 1.32-1.47; p < 0.001) and RARC (Exp[β]: 1.46; 95%-CI: 1.38-1.55; p < 0.001). Results remained unchanged when analyses were refitted in most favorable patient subgroup.CONCLUSIONS: Important regional differences in ORC and RARC THC distinguish the West from other United States regions. The THC discrepancy clearly requires closer examination to identify underlying processes that contribute to inflated costs in the West.",

keywords = "Humans, United States, Cystectomy/adverse effects, Hospital Costs, Robotic Surgical Procedures/methods, Urinary Bladder, Urinary Bladder Neoplasms/surgery, Postoperative Complications/etiology, Treatment Outcome",

author = "Benedikt Hoeh and Flammia, {Rocco Simone} and Lukas Hohenhorst and Gabriele Sorce and Francesco Chierigo and Andrea Panunzio and Zhe Tian and Fred Saad and Michele Gallucci and Alberto Briganti and Carlo Terrone and Shariat, {Shahrokh F} and Markus Graefen and Derya Tilki and Alessandro Antonelli and Kluth, {Luis A} and Andreas Becker and Chun, {Felix K H} and Karakiewicz, {Pierre I}",

year = "2023",

month = jun,

doi = "10.1016/j.suronc.2023.101924",

language = "English",

volume = "48",

pages = "101924",

journal = "SURG ONCOL",

issn = "0960-7404",

publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Regional differences in total hospital costs for radical cystectomy in the United States

AU - Hoeh, Benedikt

AU - Flammia, Rocco Simone

AU - Hohenhorst, Lukas

AU - Sorce, Gabriele

AU - Chierigo, Francesco

AU - Panunzio, Andrea

AU - Tian, Zhe

AU - Saad, Fred

AU - Gallucci, Michele

AU - Briganti, Alberto

AU - Terrone, Carlo

AU - Shariat, Shahrokh F

AU - Graefen, Markus

AU - Tilki, Derya

AU - Antonelli, Alessandro

AU - Kluth, Luis A

AU - Becker, Andreas

AU - Chun, Felix K H

AU - Karakiewicz, Pierre I

PY - 2023/6

Y1 - 2023/6

N2 - OBJECTIVES: To test for regional differences in total hospital costs (THC) across the United States in bladder cancer patients treated with open radical cystectomy (ORC) or robotic-assisted radical cystectomy (RARC).MATERIALS: We relied on the National Inpatient Sample (NIS) database (2016-2019) and stratified RC patients according to census region (Midwest, Northeast, South, West). Primary statistical analyses consisted of THC-trend analyses and multivariable log-link linear regression models, after adjustment for hospital clustering (Generalized Estimating Equation function) and discharge disposition weighting. Finally, sensitivity analysis, relying on most favorable patient cohort, was performed.RESULTS: Of 5280 eligible patients, 1441 (27%), 1031 (20%), 1854 (35%) and 954 (18%) underwent RC in the Midwest, Northeast, South and West, respectively. Median THC was 28,915$ and differed significantly between regions (Midwest: 28,105$; Northeast: 28,886$; South: 26,096$; West: 38,809$; p < 0.001). After stratification between ORC and RARC, highest THC was invariably recorded in the West: ORC 36,137$ vs 23,941-28,850$ and RARC 43,119$ vs 28,425-29,952$ (both p < 0.05). In multivariable log-link linear regression models, surgery in the West was independently associated with higher THC: ORC (Exponent beta [Exp[β]]: 1.39; 95%-CI: 1.32-1.47; p < 0.001) and RARC (Exp[β]: 1.46; 95%-CI: 1.38-1.55; p < 0.001). Results remained unchanged when analyses were refitted in most favorable patient subgroup.CONCLUSIONS: Important regional differences in ORC and RARC THC distinguish the West from other United States regions. The THC discrepancy clearly requires closer examination to identify underlying processes that contribute to inflated costs in the West.

AB - OBJECTIVES: To test for regional differences in total hospital costs (THC) across the United States in bladder cancer patients treated with open radical cystectomy (ORC) or robotic-assisted radical cystectomy (RARC).MATERIALS: We relied on the National Inpatient Sample (NIS) database (2016-2019) and stratified RC patients according to census region (Midwest, Northeast, South, West). Primary statistical analyses consisted of THC-trend analyses and multivariable log-link linear regression models, after adjustment for hospital clustering (Generalized Estimating Equation function) and discharge disposition weighting. Finally, sensitivity analysis, relying on most favorable patient cohort, was performed.RESULTS: Of 5280 eligible patients, 1441 (27%), 1031 (20%), 1854 (35%) and 954 (18%) underwent RC in the Midwest, Northeast, South and West, respectively. Median THC was 28,915$ and differed significantly between regions (Midwest: 28,105$; Northeast: 28,886$; South: 26,096$; West: 38,809$; p < 0.001). After stratification between ORC and RARC, highest THC was invariably recorded in the West: ORC 36,137$ vs 23,941-28,850$ and RARC 43,119$ vs 28,425-29,952$ (both p < 0.05). In multivariable log-link linear regression models, surgery in the West was independently associated with higher THC: ORC (Exponent beta [Exp[β]]: 1.39; 95%-CI: 1.32-1.47; p < 0.001) and RARC (Exp[β]: 1.46; 95%-CI: 1.38-1.55; p < 0.001). Results remained unchanged when analyses were refitted in most favorable patient subgroup.CONCLUSIONS: Important regional differences in ORC and RARC THC distinguish the West from other United States regions. The THC discrepancy clearly requires closer examination to identify underlying processes that contribute to inflated costs in the West.

KW - Humans

KW - United States

KW - Cystectomy/adverse effects

KW - Hospital Costs

KW - Robotic Surgical Procedures/methods

KW - Urinary Bladder

KW - Urinary Bladder Neoplasms/surgery

KW - Postoperative Complications/etiology

KW - Treatment Outcome

U2 - 10.1016/j.suronc.2023.101924

DO - 10.1016/j.suronc.2023.101924

M3 - SCORING: Journal article

C2 - 36948042

VL - 48

SP - 101924

JO - SURG ONCOL

JF - SURG ONCOL

SN - 0960-7404

ER -