Impact of caseload on total hospital charges: A direct comparison between minimally invasive and open radical prostatectomya population based study

Firas Abdollah, Lars Budus, Maxine Sun, Monica Morgan, Rupinder Johal, Rodolphe Thuret, Kevin C. Zorn, Hendrik Isbarn, Alexander Haese, Claudio Jeldres, Paul Perrotte, Francesco Montorsi, Markus Graefen, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

Abstract

Purpose We tested the relationship between caseload and total hospital charges after stratifying by minimally invasive and open radical prostatectomy. Materials and Methods We evaluated 1,188 vs 3,354 men treated with minimally invasive vs open radical prostatectomy in the Florida Hospital Inpatients data file in 2008. Caseload was defined as the count of procedures performed by each surgeon between the study start on January 1, 2008 and the date of each procedure. Patients were divided into tertiles based on their procedure specific caseload. Univariate and multivariate analysis was done to address the relation between caseload and total hospital charges for the minimally invasive and open procedures. Covariates were patient age, race, comorbidity, and length of stay. Results Median total hospital charges for minimally invasive and open radical prostatectomy were $33,234 and $33,674, respectively (p = 0.03). Median total hospital charges in the low, intermediate and high minimally invasive vs open procedure caseload tertiles were $41,765, $34,799 and $28,780 vs $35,642, $34,726 and $32,726, respectively. On multivariate analysis with the high minimally invasive caseload tertile as the reference category the increments of the probability of charges in excess of the 2008 median of $33,588 were 3.9 and 8.1-fold for the intermediate and low caseload minimally invasive procedures, and 2.5, 3.6 and 2.8-fold for the high, intermediate and low caseload open procedures, respectively (each p

Original languageEnglish
Pages (from-to)855-861
Number of pages7
JournalJournal of Urology
Volume185
Issue number3
DOIs
Publication statusPublished - Mar 2011

Keywords

  • hospital charges
  • minimally invasive
  • prostate
  • prostatectomy
  • prostatic neoplasms
  • surgical procedures

ASJC Scopus subject areas

  • Urology

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    Abdollah, F., Budus, L., Sun, M., Morgan, M., Johal, R., Thuret, R., Zorn, K. C., Isbarn, H., Haese, A., Jeldres, C., Perrotte, P., Montorsi, F., Graefen, M., & Karakiewicz, P. I. (2011). Impact of caseload on total hospital charges: A direct comparison between minimally invasive and open radical prostatectomya population based study. Journal of Urology, 185(3), 855-861. https://doi.org/10.1016/j.juro.2010.10.051