Malene Korsholm1, Dorte Gyrd-Hansen2, Ole Mogensen3, Sören Möller4, Liza Sopina5, Siv L Joergensen6, Pernille T Jensen7. 1. Research Unit of Gynecology and Obstetrics, Odense University Hospital, Kloevervaenget 10, 10th Floor, 5000 Odense C, Denmark; Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19, 5000 C, Denmark; Odense Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, J.B. Winsloews Vej 9, 3rd Floor, 5000 Odense C, Denmark; Danish Centre for Health Economics (DaCHE), Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9B, 1st Floor, 5000 Odense C, Denmark. Electronic address: malene.korsholm@rsyd.dk. 2. Danish Centre for Health Economics (DaCHE), Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9B, 1st Floor, 5000 Odense C, Denmark. Electronic address: dgh@sdu.dk. 3. Faculty of Health Institute for Clinical Medicine, Aarhus University and Department of Gynecology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark. Electronic address: olemog@rm.dk. 4. Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19, 5000 C, Denmark; Odense Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, J.B. Winsloews Vej 9, 3rd Floor, 5000 Odense C, Denmark. Electronic address: soren.moller@rsyd.dk. 5. Danish Centre for Health Economics (DaCHE), Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9B, 1st Floor, 5000 Odense C, Denmark. Electronic address: lsopina@sdu.dk. 6. Research Unit of Gynecology and Obstetrics, Odense University Hospital, Kloevervaenget 10, 10th Floor, 5000 Odense C, Denmark; Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19, 5000 C, Denmark; Odense Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, J.B. Winsloews Vej 9, 3rd Floor, 5000 Odense C, Denmark. Electronic address: siv.lykke.joergensen@rsyd.dk. 7. Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19, 5000 C, Denmark; Faculty of Health Institute for Clinical Medicine, Aarhus University and Department of Gynecology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark. Electronic address: pernille_jensen@dadlnet.dk.
Abstract
OBJECTIVE: The majority of cost-studies related to robotic surgery has a short follow-up and primarily report the costs from the index surgery. The aim of this study was to evaluate the long-term resource consequences of introducing robotic surgery for early stage endometrial cancer in Denmark. METHODS: The study included all women with early stage endometrial cancer who underwent robotic, laparoscopic and open access surgery from January 2008 to June 2015. Data was linked from national databases to determine resource consumption and costs from hospital treatments, outpatient contacts, primary health care sector visits, labor market affiliation and prescription of medication. Each patient was observed in a period of 12 months before- and after surgery. The key exposure variable was women who were exposed to robotic surgery compared to those who were not. RESULTS: A total of 4133 women underwent surgery for early stage endometrial cancer. The study found additional costs of $7309 (95% confidence interval [CI] 2100-11,620, P = 0.001) per patient in the group exposed to robotic surgery including long-term costs post-surgery compared to the non-exposed group (non-robotic group). When controlling for time trends, the introduction of robotic surgery did not reduce the number of bed days (mean diff -0.42, 95% CI -3.03-2.19, P = 0.752). CONCLUSIONS: The introduction of robotic surgery for early stage endometrial cancer did not generate any long-term cost savings. The additional costs of robotic surgery were primarily driven by the index surgery. Any reduction in bed days could be explained by time trends.
OBJECTIVE: The majority of cost-studies related to robotic surgery has a short follow-up and primarily report the costs from the index surgery. The aim of this study was to evaluate the long-term resource consequences of introducing robotic surgery for early stage endometrial cancer in Denmark. METHODS: The study included all women with early stage endometrial cancer who underwent robotic, laparoscopic and open access surgery from January 2008 to June 2015. Data was linked from national databases to determine resource consumption and costs from hospital treatments, outpatient contacts, primary health care sector visits, labor market affiliation and prescription of medication. Each patient was observed in a period of 12 months before- and after surgery. The key exposure variable was women who were exposed to robotic surgery compared to those who were not. RESULTS: A total of 4133 women underwent surgery for early stage endometrial cancer. The study found additional costs of $7309 (95% confidence interval [CI] 2100-11,620, P = 0.001) per patient in the group exposed to robotic surgery including long-term costs post-surgery compared to the non-exposed group (non-robotic group). When controlling for time trends, the introduction of robotic surgery did not reduce the number of bed days (mean diff -0.42, 95% CI -3.03-2.19, P = 0.752). CONCLUSIONS: The introduction of robotic surgery for early stage endometrial cancer did not generate any long-term cost savings. The additional costs of robotic surgery were primarily driven by the index surgery. Any reduction in bed days could be explained by time trends.
Authors: Antonio Raffone; Antonio Travaglino; Diego Raimondo; Dominga Boccia; Martino Vetrella; Paolo Verrazzo; Marcello Granata; Paolo Casadio; Luigi Insabato; Antonio Mollo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-06-19 Impact factor: 4.447