腹腔镜前列腺根治术与耻骨后前列腺根治术的住院费用比较分析

Comparative Analysis of Hospitalization Cost Between Laparoscopic and Open Radical Prostatectomy

目的利用重庆市某高校附属医院住院费用数据,比较腹腔镜前列腺根治术(laparoscopic radical prostatectomy,LRP)和耻骨后前列腺根治术(radical retropubic prostatectomy,RRP)住院费用的差异,探讨导致两者住院费用差异的主要原因。方法回顾分析该院2013年1月~2014年12月所有病理诊断为前列腺癌并行前列腺根治术(radical prostatectomy,RP)的83例出院患者的病历资料(LRP 54例,RRP 29例)。摘录病案首页的社会人口学信息、住院诊疗信息和住院费用信息,住院费用信息包含药费、检查费、治疗费、手术室费用、外科材料费和其他费用,比较LRP和RRP住院费用的差异。结果在年龄、住院时间、Gleason评分、临床分期以及合并症方面2组无显著性差异(P>0.05)。LRP住院总费用高于RRP[LRP(55 695±11 130)元,RRP(45 955±23 011)元,t=2.148,P=0.039],2组住院总费用的主要差异在治疗费(中位数LRP 5862元,RRP4587元,Z=-2.511,P=0.011),手术室费用(中位数LRP 9620元,RRP 9265元,Z=-2.197,P=0.028)以及外科材料费(中位数LRP 24 911元,RRP 16 692元,Z=-3.009,P=0.003)。2组检查费[(LRP(8521±2179)元,RRP(8256±3288)元,t=0.390,P=0.669]和药费(中位数LRP 10 274元,RRP 10 182元,Z=-0.096,P=0.924)无显著性差异(P>0.05)。结论在临床教学医院,LRP的住院总费用高于RRP,其主要原因是LRP较高的手术室费用和外科材料费。

Objective To compare the difference of hospitalization expenses between laparoscopic radical prostatectomy（ LRP） and open radical retropubic prostatectomy（ RRP） in an actual clinical setting,and to explore main reasons leading to the difference. Methods We analyzed hospitalization expenses data from this hospital. Medical records of 83 patients undergoing radical prostatectomy（ 54 cases of LRP and 29 cases of RRP） with biopsy-proven prostate cancer between January 2013 and December2014 were retrospectively analyzed. The sociodemographic characteristics,disease diagnosis and treatment,and expense information were collected. Detailed costs information for pharmacy,examination,treatment,operating room,surgical supplies and other expenses were obtained. The hospitalization expenses of LRP and RRP were analyzed and compared. Results Descriptive characteristics（ age,length of hospital stay,Gleason scores,clinical stage,co-morbidity） were similar between the two groups. The total hospitalization expense of the procedure was significantly higher for LRP than for RRP（ $ 55 695 ± 11 130 vs. $ 45 955 ± 23 011,t =2. 148,P = 0. 039）. The main differences of hospitalization expense were in treatment expenses（ median of LRP： $ 5862 vs. RRP：$ 4587,Z =- 2. 511,P = 0. 011）,operating room costs（ LRP： $ 9620 vs. RRP： $ 9265,Z =- 2. 197,P = 0. 028）,and surgical supplies costs（ LRP： $ 24 911 vs. RRP： $ 16 692,Z =- 3. 009,P = 0. 003）. The examination expenses（ LRP： $ 8521 ± 2179 vs. RRP： $ 8256 ± 3288,t = 0. 390,P = 0. 669） and pharmacy costs（ LRP： $ 10 274 vs. RRP： $ 10 182,Z =- 0. 096,P =0. 924） were not significantly different. Conclusion In this clinical teaching hospital,the hospitalization expense of LRP issignificantly higher than the RRP,which is predominantly due to the higher operating room cost and higher surgical supplies cost.