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

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). We relied on the National Inpatient Sample (NIS) database (2016–2019) and stratified RC patient...

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Published in:Surgical oncology 2023-06, Vol.48, p.101924-101924, Article 101924
Main Authors: 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.
Format: Article
Language:English
Subjects:
Bladder cancer
Comparison
Cystectomy - adverse effects
Healthcare expenditure
Hospital Costs
Humans
NIS
Population-based
Postoperative Complications - etiology
Radical cystectomy
Robotic Surgical Procedures - methods
Total hospital costs
Treatment Outcome
United States
Urinary Bladder
Urinary Bladder Neoplasms - surgery
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Summary: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). 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. 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 
ISSN:0960-7404
1879-3320
DOI:10.1016/j.suronc.2023.101924