Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S28-8

(P)

A COMAPARATIVE COST ANALYSIS OF ROBOTIC-ASSISTED SURGERY(RS)

VERSUS LAPAROSCOPIC SURGERY (LS) AND OPEN SURGEY (OS) IN A PEDIATRIC

HOSPITAL

Mario DE GENNARO

, Matteo RITROVATO

, Giulia TEDESCO

, Giovanni TORINO

, Maria Luisa CAPITANUCCI

and Pietro

DERRICO

1) Children's Hospital Bambino Gesu', Dep. Urology and Nephrology. Urology, Robotic Surgery and Urodynamics Unit,

Roma, ITALY - 2) Children's Hospital Bambino Gesu', Health Technology Assessment and Safety Research, Roma, ITALY

PURPOSE

The rising costs of health services oblige to cost-effective analyses for new technologies. The Robotic Surgery (robotic-

assisted surgery (RS) offers well established advantages estabilished in adults, while in children the cost-effectiveness is

still controversial

MATERIAL AND METHODS

A working group of Children’s Hospital sought to compare the costs of RS with laparoscopic (laparoscopic (LS) and

open surgery (OS), analyzing also its impact on hospital organization. We performed a Break-even analysis (BEA) and

cost-minimization analysis (CMA) from hospital system data and team expertise. BEA was calculated in not only a basa-

case scenario, but also changing the parameters between pre-defined ranges. A deterministic sensitivity analysis (DSA)

was conducted to outline the variety of management scenarios as: number of surgeons, initial expenditures,

consumables and supplies, manufacturer hypothetical sell proposal, maintenance annual fees. By the weighted case mix

of 176 selected cases treated in the hospital in 2012, we calculated the Contribution Margin (CM) of RS, LS and OS

procedures.

RESULTS

CM analysis shows a greater economic profit for OS and LS, hence considering RS the most expensive alternative. The

BEA suggested that, in the base scenario, at least 349 annual interventions are needed; while it ranged from 103 to 458

procedures in different scenarios, and it is 272 considering urological cases only.

CONCLUSIONS

Robotic surgey implies increased hospital costs, due to initial investment and maintenance, and to procedure costs

exceeding the tariffs for reimbursement. Solutions may be to define training and clinical programs through partnership

with other hospitals, and to claim adequate NHS reimbursements