Comparing Outpatient and Inpatient Robotic Radical Prostatectomy

By Patrick Daly - Last Updated: December 2, 2022

A recent study, presented at the 23rd Annual Meeting of the Society of Urologic Oncology, assessed costs, safety, and patient satisfaction of outpatient and inpatient robotic-assisted radical prostatectomy (RARP).

Lead author and presenter, Emily Cheng, explained that the onset of the COVID pandemic increased use of outpatient RARP. According to Cheng, the researchers found a $1386 cost reduction with outpatient RARP and no differences in adverse events or patient satisfaction compared with inpatient.

Outpatient RARP Offers Significant Cost Savings Over Inpatient

The study included 81 outpatients and 71 inpatients who received RARP between February 2020 and February 2022. Researchers tracked patients’ care pathways to determine resource utilization based on time-driven activity-based costing (TDABC), including the capacity cost rate for personnel, equipment, and space. They also collected 46 inpatient and 55 outpatient responses to the Patient Satisfaction Questionnaire within 30 days of RARP. The Clavien-Dindo Classification scale was used to rate adverse events.

According to the researchers, the inpatient and outpatient groups had comparable mean age, body mass index, and comorbidities. Reportedly, outpatient RARP carried a cost reduction of 13.54% ($1386.78) compared with inpatient RARP. The authors noted the largest difference was inpatient hospital admission, which was $1181.41 for an overnight stay.

In addition, the investigators observed no significant difference in mean patient satisfaction scores on the survey (P>.05 for all selected questions). Of note, the outpatient group had a complication rate of 7.4% compared with 13.9% in the inpatient group. Events included urinary tract infections, incision infections, and deep vein thrombosis. There were no Clavien complications above grade 2 for either group, the authors added.

Cheng and colleagues concluded that “outpatient RARP is a feasible care pathway with significant cost savings, a satisfactory patient experience, and similar outcomes, and it aligns with principles of value-based care.”