Long term resource consequences of a nationwide introduction of robotic surgery for women with early stage endometrial cancer

Malene Korsholm*, Dorte Gyrd-Hansen, Ole Mogensen, Sören Möller, Liza Sopina, Siv L. Joergensen, Pernille T. Jensen

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftGynecologic Oncology
Vol/bind154
Udgave nummer2
Sider (fra-til)411-419
ISSN0090-8258
DOI
StatusUdgivet - 1. aug. 2019

Fingeraftryk

Robotics
Endometrial Neoplasms
Confidence Intervals
Health Care Sector
Cost Savings
Hospital Costs
Denmark
Prescriptions
Primary Health Care
Outpatients
Databases

Citer dette

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title = "Long term resource consequences of a nationwide introduction of robotic surgery for women with early stage endometrial cancer",
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.",
keywords = "Costs of care, Endometrial cancer, Long follow-up, Resource consumption, Robotic surgery",
author = "Malene Korsholm and Dorte Gyrd-Hansen and Ole Mogensen and S{\"o}ren M{\"o}ller and Liza Sopina and Joergensen, {Siv L.} and Jensen, {Pernille T.}",
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T1 - Long term resource consequences of a nationwide introduction of robotic surgery for women with early stage endometrial cancer

AU - Korsholm, Malene

AU - Gyrd-Hansen, Dorte

AU - Mogensen, Ole

AU - Möller, Sören

AU - Sopina, Liza

AU - Joergensen, Siv L.

AU - Jensen, Pernille T.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - 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.

AB - 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.

KW - Costs of care

KW - Endometrial cancer

KW - Long follow-up

KW - Resource consumption

KW - Robotic surgery

U2 - 10.1016/j.ygyno.2019.05.027

DO - 10.1016/j.ygyno.2019.05.027

M3 - Journal article

VL - 154

SP - 411

EP - 419

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -