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Durand M, Bentellis I, Shaikh A, et al. Évaluation médico-economique de l’impact de mesures d’adaptation au virage de la chirurgie robot-assistée en urologie. . Prog Urol. 2021;doi: 10.1016/j.purol.2020.12.019.
Durand, M., Bentellis, I., Shaikh, A., Barthe, F., Imbert de la Phalecque, L., Tibi, B., Ahallal, Y., Elleboode, B., Guepratte, C., Acloque, D., Lechevallier, E., & Chevallier, D. (2021). Évaluation médico-economique de l’impact de mesures d’adaptation au virage de la chirurgie robot-assistée en urologie. . Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie, . https://doi.org/10.1016/j.purol.2020.12.019
Durand, M, et al. "Évaluation médico-economique de l’impact de mesures d’adaptation au virage de la chirurgie robot-assistée en urologie." . Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie vol. (2021). doi: https://doi.org/10.1016/j.purol.2020.12.019
Durand M, Bentellis I, Shaikh A, Barthe F, Imbert de la Phalecque L, Tibi B, Ahallal Y, Elleboode B, Guepratte C, Acloque D, Lechevallier E, Chevallier D. Évaluation médico-economique de l’impact de mesures d’adaptation au virage de la chirurgie robot-assistée en urologie. . Prog Urol. 2021 Jun 18; doi: 10.1016/j.purol.2020.12.019. Epub 2021 Jun 18. French. PMID: 34154963.
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Prog Urol. 2021 Jun 18; doi: 10.1016/j.purol.2020.12.019. Epub 2021 Jun 18.

[No title available]

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie

[Article in French]
M Durand, I Bentellis, A Shaikh, F Barthe, L Imbert de la Phalecque, B Tibi, Y Ahallal, B Elleboode, C Guepratte, D Acloque, E Lechevallier, D Chevallier

Affiliations

  1. Service d'Urologie, Andrologie, Transplantation Rénale, Hôpital Pasteur 2, CHU de Nice; Inserm U1081 - CNRS UMR 7284 Université de Nice Côte d'Azur. Electronic address: [email protected].
  2. Service d'Urologie, Andrologie, Transplantation Rénale, Hôpital Pasteur 2, CHU de Nice.
  3. Direction Générale, ARS Nouvelle-Aquitaine.
  4. Direction Générale, CHU de Nice.
  5. Service de contrôle de Gestion, CHU de Nice.
  6. Service d'Urologie et Transplantation Rénale, Hôpital de la Conception, APHM - Aix-Marseille Université - Campus Timone - Faculté des Sciences Médicales et Paramédicales, boulevard J Moulin, 13385 Marseille.

PMID: 34154963 DOI: 10.1016/j.purol.2020.12.019

Abstract

INTRODUCTION: The development of robot-assisted urological surgery is held back by the lack of robust medico-economic analyses and their heterogeneity. We conducted a medico-economic study to evaluate the implementation of measures to optimize the transition to robotic surgery.

METHOD: We carried out a single-center, controlled study from the point of view of the public healthcare establishment for 4 years. Economic data collection was based on a micro-costing method and revenues from stay-related groups. Clinical data corresponded to mean lengths of stay, operating duration, complications and stays in intensive care. The measures to optimize the transition to robotic, implemented mid-study period, enabled before/after comparison.

RESULTS: Altogether, 668 patients undergoing robotic surgery were included. Robotic activity increased significantly from periods 1 to 2 to 256% (P=<0.001) as did the overall proportion of robotic by 45% to 85% (P=<0.001). The mean lengths of stay fell significantly, 6.8 d vs. 5.1 d (P<0.001). Costs and revenues increased significantly, resulting in a persistent deficit for the activity €226K vs. €382K (P=<0.001). With increased volume of activity, the deficit per operation and the cost per minute of robotic operating room fell significantly, €3,284 vs. €1,474/procedure (P=<0.001) and €27 vs €24/min (P=<0.029), tending towards a break-even point (=zero deficit) at 430 operations per year.

CONCLUSIONS: Robotic-assisted surgery can be significantly optimized by implementing measures for the robotic turn to reach a break-even point at 430 operations per year. A better multidisciplinary case mix could lower the break-even volume of activity in short term.

LEVEL OF EVIDENCE: 3.

Copyright © 2021 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Keywords: Analyse de coût; Analyse médico-économique; Chirurgie robotique; Cost-Benefit Analysis; Health economics; Humans; Models; Modèle; Outcomes; Performance; Pertinence; Relevance; Robotic Surgical Procedures/economics; Robotic Surgical Procedures/standards; Valeur; Value; Économie de santé; Étude coût-bénéfice

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