A comparative cost analysis of robotic-assisted surgery versus laparoscopic surgery and open surgery: the necessity of investing knowledgeably

Tedesco, Giorgia; Faggiano, Francesco; Leo, Erica; Derrico, Pietro; Ritrovato, Matteo

doi:10.1007/s00464-016-4852-7

Cited by 32 publications

(21 citation statements)

References 11 publications

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“…From an economic perspective, a contribution margin may be a more meaningful parameter for cost analyses for centers interested in offering a robotic approach. Contribution margin is the difference between total payments and direct cost, representing a surplus that may be used to offset amortization and robot-specific indirect cost for the institution (22).…”

Section: Discussionmentioning

confidence: 99%

Understanding the financial cost of robotic lobectomy: calculating the value of innovation?

Singer¹,

Kneuertz²,

D’Souza³

et al. 2019

Ann. Cardiothorac. Surg.

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Background: The advantages of a minimally-invasive surgical approach compared to conventional open thoracotomy for lung resection have been previously described. While robot-assisted thoracoscopic surgery (RATS) has shown comparable clinical outcomes for lobectomy as compared with video-assisted thoracic surgery (VATS), the cost and inherent value associated with the robotic technology remains a main concern. Methods: We conducted a systematic review of the literature on the cost of RATS lobectomy using studies published prior to December 2017 on MEDLINE and EMBASE.

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Section: Discussionmentioning

confidence: 99%

Understanding the financial cost of robotic lobectomy: calculating the value of innovation?

Singer¹,

Kneuertz²,

D’Souza³

et al. 2019

Ann. Cardiothorac. Surg.

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“…9,10 In the current era of bundled payments and value-based care, surgeons are faced with increasing scrutiny to perform procedures associated with the best possible outcomes relative to dollars spent, 11 and hospitals are carefully considering investments in expensive technology. 12 Previous head-to-head comparisons of lobectomy approaches, including those of the early robotic experience, have indicated notable differences in cost. [13][14][15][16] However, since the experience with robotic lung surgery has since evolved, these data may not accurately reflect the current outcomes and associated cost at high-volume centers.…”

Section: Perspectivementioning

confidence: 99%

Hospital cost and clinical effectiveness of robotic-assisted versus video-assisted thoracoscopic and open lobectomy: A propensity score–weighted comparison

Kneuertz

Singer

D’Souza

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: To compare cost and perioperative outcomes of robotic, videoassisted thoracoscopic surgery (VATS), and open surgical approaches to pulmonary lobectomy.Methods: Patients who underwent pulmonary lobectomy between 2012 and 2017 at a single tertiary referral center were reviewed. Propensity score adjustment by inverse probability of treatment weighting (IPTW) was used to balance baseline patient characteristics. The primary outcomes of the study were direct hospital cost and perioperative outcomes, including operative time, complications rates, and length of stay. Indirect cost and charges were secondary financial outcomes.From the

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“…Clinicians, health professionals and hospital managers perform the evaluative process, which is driven by clinical competences trying to respect budget restrictions [29,[37][38][39]. Since drugs are already assessed by National Medicine Agencies [40], HB-HTA activities concern mainly medical devices, equipment and/or procedures [39,[41][42][43]. Lafortune et al argue that the evaluation objective of HB-HTA has evolved from the capital-intensive technologies to clinical outcomes and delivery models [44].…”

Section: Health Technology Assessment Across the National Health Systemmentioning

confidence: 99%

Higher Sustainability and Lower Opportunistic Behaviour in Healthcare: A New Framework for Performing Hospital-Based Health Technology Assessment

2018

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Innovative health technology deployment represents the primary challenge within the sustainability of public health systems. On one hand, new technologies may potentially improve access to care and the quality of services. On the other hand, their rapid evolution and broad implications on existing procedures increase the risk to adopt technologies that are not value for money. As a consequence, Health Technology Assessment (HTA) is a critical process at each level of the National Health System. Focusing on the organisational level, this paper explores the current practices of Hospital-Based HTA (HB-HTA) in terms of management, control and behaviours of various actors involved. Among several tasks, decision-makers are appointed at managing the conflict of interest around health technology development, that could pave the way for corruption or other misleading behaviours. Accordingly, the purpose of the study is proposing a new strategic framework, named Health Technology Balanced Assessment (HTBA), to foster hospital-based health technology management aimed to align strategy and actions. The conceptual model is developed on three perspectives (clinical, economic and organisational) to make the actors involved in the assessment (clinicians, health professionals, hospital managers and patients) aware of the impact of new technology on the value chain. Besides supporting the decision-making process, such a tool represents support for the internal control system as a whole. By promoting structured evaluation, it increases transparency and accountability of public health organisations. Moreover, in the long run, the framework proposed will be useful to reach selected United Nations Sustainable Development Goals (UN SDGs) to enhance the quality of healthcare in the future.

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A comparative cost analysis of robotic-assisted surgery versus laparoscopic surgery and open surgery: the necessity of investing knowledgeably

Cited by 32 publications

References 11 publications

Understanding the financial cost of robotic lobectomy: calculating the value of innovation?

Understanding the financial cost of robotic lobectomy: calculating the value of innovation?

Hospital cost and clinical effectiveness of robotic-assisted versus video-assisted thoracoscopic and open lobectomy: A propensity score–weighted comparison

Higher Sustainability and Lower Opportunistic Behaviour in Healthcare: A New Framework for Performing Hospital-Based Health Technology Assessment

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