Mp77-13 outpatient versus inpatient robotic assisted radical prostatectomy: complications, time driven activities based costing and patient satisfaction

You have accessJournal of UrologyCME1 Apr 2023MP77-13 OUTPATIENT VERSUS INPATIENT ROBOTIC ASSISTED RADICAL PROSTATECTOMY: COMPLICATIONS, TIME DRIVEN ACTIVITIES BASED COSTING AND PATIENT SATISFACTION Emily Cheng, Aaron Laviana, Spyridon Basourakos, Sofia Gereta, Alec Zhu, Leonardo Borregales, Xiangmei Gu, Miko Yu, Chunmei Mckernan, Siwen Xie, Christopher Barbieri, Douglas Scherr, and Jim Hu Emily ChengEmily Cheng More articles by this author , Aaron LavianaAaron Laviana More articles by this author , Spyridon BasourakosSpyridon Basourakos More articles by this author , Sofia GeretaSofia Gereta More articles by this author , Alec ZhuAlec Zhu More articles by this author , Leonardo BorregalesLeonardo Borregales More articles by this author , Xiangmei GuXiangmei Gu More articles by this author , Miko YuMiko Yu More articles by this author , Chunmei MckernanChunmei Mckernan More articles by this author , Siwen XieSiwen Xie More articles by this author , Christopher BarbieriChristopher Barbieri More articles by this author , Douglas ScherrDouglas Scherr More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical prostatectomy lengths of stay decreased with ketorolac analgesia and adoption of robotic assisted radical prostatectomy (RARP). During the COVID-19 pandemic, the transition to outpatient RARP freed up critically needed hospital beds. The healthcare cost reduction afforded by the shift to outpatient RARP and its effect on patient satisfaction has yet to be explored. We compared healthcare costs, patient satisfaction and complications for outpatient vs. inpatient RARP. METHODS: We identified and compared a series of consecutive RARP performed as outpatient vs. inpatient and determined the capacity cost rate for every resource, including personnel, equipment, and space. After the lifting of hospital restrictions, men were given the option of inpatient vs. outpatient RARP. We also administered a validated Patient Satisfaction Outcome Questionnaire (PSOQ) post-operatively and compared median scores in perceived outcomes and satisfaction. A time-driven activity-based costing (TDABC) analysis was applied to compare the total costs of care for RARP performed. Finally, we captured complications within 30 days of surgery using the Clavien-Dindo classification. We used multivariable regression to adjust for age, race, BMI, and ASA classification to assess the impact of outpatient vs. inpatient RARP on complications. RESULTS: There were no significant differences in patient characteristics for outpatient (n=145) vs. inpatient (n=80) RARP. When given the choice, 86.6% of men elected for outpatient vs. inpatient RARP. Outpatient RARP netted a $1387 (13.5%) cost reduction compared to inpatient RARP. There were no significant differences in outpatient vs. inpatient median satisfaction survey scores or complications within 30 days (11.0% vs. 11.3%, p=0.961). CONCLUSIONS: Outpatient RARP can be safely performed, with similar outcomes and compared to inpatient RARP. Outpatient RARP has significantly lower costs compared to inpatient RARP while maintaining similar patient satisfaction outcomes. Source of Funding: 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. The remaining authors report no further disclosures related to this work © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1107 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Cheng More articles by this author Aaron Laviana More articles by this author Spyridon Basourakos More articles by this author Sofia Gereta More articles by this author Alec Zhu More articles by this author Leonardo Borregales More articles by this author Xiangmei Gu More articles by this author Miko Yu More articles by this author Chunmei Mckernan More articles by this author Siwen Xie More articles by this author Christopher Barbieri More articles by this author Douglas Scherr More articles by this author Jim Hu More articles by this author Expand All Advertisement PDF downloadLoading ...