Post robotic investment: Cost consequences and impact on length of stay for obese women with endometrial cancer

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

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Introduction: The aim of the study was to investigate whether robotic-assisted surgery is associated with lower incremental resource use among obese patients relative to non-obese patients after a Danish nationwide adoption of robotic-assisted surgery in women with early-stage endometrial cancer. This is a population-based cohort study based on registers and clinical data. Material and methods: All women who underwent surgery (robotic, laparoscopic and laparotomy) from 2008 to 2015 were included and divided according to body mass index (<30 and ≥30). Robotic-assisted surgery was gradually introduced in Denmark (2008–2013). We compared resource use post-surgery in obese vs non-obese women who underwent surgery before and after a nationwide adoption of robotic-assisted surgery. The key exposure variable was exposure to robotic-assisted surgery. Clinical and sociodemographic data were linked with national register data to determine costs and bed days 12 months before and after surgery applying difference-in-difference analyses. Results: In total, 3934 women were included. The adoption of robotic-assisted surgery did not demonstrate statistically significant implications for total costs among obese women (€3,417; 95% confidence interval [CI] −€854 to €7,688, p = 0.117). Further, for obese women, a statistically significant reduction in bed days related to the index hospitalization was demonstrated (−1.9 bed days; 95% CI −3.6 to −0.2, p = 0.025). However, for non-obese women, the adoption of robotic-assisted surgery was associated with statistically significant total costs increments of €9,333 (95% CI €3,729–€1,4936, p = 0.001) and no reduction in bed days related to the index hospitalization was observed (+0.9 bed days; 95% CI −0.6 to 2.3, p = 0.242). Conclusions: The national investment in robotic-assisted surgery for endometrial cancer seems to have more modest cost implications post-surgery for obese women. This may be partly driven by a significant reduction in bed days related to the index hospitalization among obese women, as well as reductions in subsequent hospitalizations.

Original languageEnglish
JournalActa Obstetricia et Gynecologica Scandinavica
Volume100
Issue number10
Pages (from-to)1830-1839
ISSN0001-6349
DOIs
Publication statusPublished - Oct 2021

Keywords

  • costs of care
  • endometrial cancer
  • length of stay
  • long follow-up
  • obese women
  • resource consumption
  • robotic-assisted laparoscopic hysterectomy

Fingerprint

Dive into the research topics of 'Post robotic investment: Cost consequences and impact on length of stay for obese women with endometrial cancer'. Together they form a unique fingerprint.

Cite this