Time-Driven Activity-based Costing and Outcomes of Same-Day Discharge vs Inpatient Robotic Partial and Radical Nephrectomy - 20/06/24
Résumé |
Objective |
To assess the outcomes, total healthcare utilization, and cost savings for same-day discharge (SDD) vs inpatient robotic-assisted partial nephrectomy (RAPN) and robotic-assisted radical nephrectomy (RARN).
Methods |
We compared 146 RAPNs and 65 RARNs consecutively performed as SDD (RAPN=21, RARN=9) vs inpatient (RAPN=125, RARN=56) from April 2015 to May 2023 at two academic medical centers. We collected baseline demographics, perioperative characteristics, and 30-day complications. We applied the Time-Driven Activity-Based Costing analysis to compare total costs of RAPN and PARN throughout the cycle of care, including inpatient vs SDD.
Results |
Baseline demographics and comorbidities were similar between patients undergoing inpatient vs SDD RAPN and RARN. One Clavien-Dindo grade II complication (3.3%) requiring readmission due to wound infection for antibiotics occurred after SDD RAPN; no complications occurred after SDD RARN. Two unscheduled office or emergency department visits (6.7%) occurred after SDD RAPN for surgical-site infection and urinary retention. SDD vs inpatient RAPN and RARN demonstrated a $3091 (18%) and $4003 (25%) overall cost reduction, respectively.
Conclusion |
SDD RAPN and RARN result in cost savings of 18%-25% without a difference in complications, and thereby improves value-based care for appropriately selected patients.
Le texte complet de cet article est disponible en PDF.Plan
| Funding Support: Jim C. Hu receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758, R01 CA259173, R01 CA273031, PCORI CER-2019C1-15682 and CER-2019C2-17372 and a Prostate Cancer Foundation Challenge Award. He is also a consultant for Intuitive Surgical and Pfizer. |
|
| Gal Wald and Sofia Gereta have contributed equally to the publication of this manuscript. |
Vol 188
P. 11-17 - juin 2024 Retour au numéro
Article précédent
- The Impact of Single-Use Cystoscopes on Clinical Time Workflow in an Outpatient Setting
- Robert Medairos, Francois Soto-Palou, David L. Barquin, Ezra J. Margolin, Rachel Locascio, Jodi Antonelli, Glenn Preminger, Michael Lipkin
- Hydronephrosis as a Late Complication of ProACT Implantation
- Carmelo Morreale, Andrea Gregori, Stefania Ranzoni, Michele Rizzo, Stefano Bucci, Giovanni Liguori
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?