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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Understanding differences between high and low volume hospitals for radical prostatectomy.
Wendy Siu1, Stephanie Daignault, David C Miller
1Department of Urology, Division for Health Services Research, The University of Michigan, Ann Arbor, MI 48109, USA. siuw@med.umich.edu
Urologic Oncology
|May 3, 2008
Summary
Patients treated at high-volume radical prostatectomy centers have shorter hospital stays. High-volume centers offer better specialized medical and ancillary services, reducing prolonged length of stay (LOS).
Area of Science:
- Urology
- Health Services Research
- Oncology
Background:
- Hospital volume is a marker for quality of care.
- Specialized services may impact patient outcomes after radical prostatectomy.
Purpose of the Study:
- To evaluate the impact of specialized medical and ancillary services at low versus high volume prostatectomy centers on prolonged length of stay (LOS) outcomes after radical prostatectomy.
Main Methods:
- The Nationwide Inpatient Sample was used to identify 9,266 patients who underwent prostatectomy in 2003.
- Logistic regression models were used to estimate differences in health services availability and their effect on prolonged LOS (>90 percentile, 5 days).
Main Results:
- Patients at low-volume hospitals had a 19.0% prolonged LOS compared to 5.4% at high-volume hospitals (unadjusted OR 4.2).
- After adjustments, patients at low-volume centers were 3.3 times more likely to have prolonged hospitalization (95% CI 1.9-5.6).
- Adjusting for hospital differences reduced the volume effect by 14.8%.
Conclusions:
- Significant differences exist in the healthcare environment between low and high volume radical prostatectomy centers.
- High-volume hospitals generally provide a broader range of medical and post-prostatectomy services.
- Hospital volume is associated with prolonged length of stay after radical prostatectomy.
