Variation in prostate surgery costs and outcomes in the USA: robot-assisted versus open radical prostatectomy

Aim: To compare perioperative complications, inpatient cost and length of stay between robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP) using National Inpatient Sample data from 2010 to 2015. Patients & methods: A total of 69,009 records with RARP or ORP were analyzed using multivariate logistic regression and generalized linear models. Results: The RARP had superior perioperative outcomes at a higher cost (adjusted mean difference=2956; 95% CI: $2822-$3090) and shorter length of stay (mean difference=0.85; 95% CI: 0.81-0.89) compared with ORP. Mean cost of RARP was lowest in urban teaching, private invest-own, high volume and northeast region hospitals and highest for black men. Conclusion: Compared with ORP, RARP had significantly better perioperative outcomes at a higher cost.