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In-hospital cost analysis of prostatic artery embolization compared to transurethral resection of the prostate: Post hoc analysis of a randomized controlled trial


Müllhaupt, Gautier; Hechelhammer, Lukas; Engeler, Daniel S; Güsewell, Sabine; Betschart, Patrick; Zumstein, Valentin; Kessler, Thomas M; Schmid, Hans-Peter; Mordasini, Livio; Abt, Dominik (2019). In-hospital cost analysis of prostatic artery embolization compared to transurethral resection of the prostate: Post hoc analysis of a randomized controlled trial. BJU International, 123(6):1055-1060.

Abstract

OBJECTIVES
To perform a post-hoc analysis of in-hospital costs incurred in a randomized controlled trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP).

PATIENTS AND METHODS
In-hospital costs arising from PAE and TURP were calculated using detailed expenditure reports provided by the hospital accounts department. Total costs including those arising from surgical and interventional procedures, consumables, personnel, and accommodation were analysed for all of the study participants and compared between PAE and TURP using descriptive analysis and two-sided t-tests adjusted for unequal variance within groups (Welch t-test).

RESULTS
Mean total costs per patient (± SD) were higher for TURP at €9,137 ± 3,301 than for PAE at €8,185 ± 1,630. The mean difference (md) of €952 was not statistically significant (p=0.07). While the mean procedural costs were significantly higher for PAE (md €623 (p=0.009)), costs apart from the procedure were significantly lower for PAE with an md of €1,627 (p< 0.001). Procedural costs of €1,433 ± 552 for TURP were mainly incurred by anaesthesia, whereas €2,590 ± 628 for medical supplies were the main cost factor for PAE.

CONCLUSIONS
Since in-hospital costs are similar but PAE and TURP have different efficacy and safety profiles, the patient's clinical condition and expectations - rather than finances - should be taken into account when deciding between PAE and TURP. This article is protected by copyright. All rights reserved.

Abstract

OBJECTIVES
To perform a post-hoc analysis of in-hospital costs incurred in a randomized controlled trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP).

PATIENTS AND METHODS
In-hospital costs arising from PAE and TURP were calculated using detailed expenditure reports provided by the hospital accounts department. Total costs including those arising from surgical and interventional procedures, consumables, personnel, and accommodation were analysed for all of the study participants and compared between PAE and TURP using descriptive analysis and two-sided t-tests adjusted for unequal variance within groups (Welch t-test).

RESULTS
Mean total costs per patient (± SD) were higher for TURP at €9,137 ± 3,301 than for PAE at €8,185 ± 1,630. The mean difference (md) of €952 was not statistically significant (p=0.07). While the mean procedural costs were significantly higher for PAE (md €623 (p=0.009)), costs apart from the procedure were significantly lower for PAE with an md of €1,627 (p< 0.001). Procedural costs of €1,433 ± 552 for TURP were mainly incurred by anaesthesia, whereas €2,590 ± 628 for medical supplies were the main cost factor for PAE.

CONCLUSIONS
Since in-hospital costs are similar but PAE and TURP have different efficacy and safety profiles, the patient's clinical condition and expectations - rather than finances - should be taken into account when deciding between PAE and TURP. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 June 2019
Deposited On:04 Jan 2019 12:50
Last Modified:25 Sep 2019 00:01
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1464-4096
Additional Information:This is the peer reviewed version of the following article: BJU Int. 2018 Dec 22. doi: 10.1111/bju.14660, which has been published in final form at https://doi.org/10.1111/bju.14660. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. (http://www.wileyauthors.com/self-archiving)
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/bju.14660
PubMed ID:30578705

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