Hospital-based direct cost comparison between open simple prostatectomy and HoLEP

Area of Science:

• Urology
• Health Economics
• Surgical Outcomes

Background:

• Benign prostatic hyperplasia (BPH) is a common condition requiring surgical intervention.
• Open simple prostatectomy (OSP) and holmium laser enucleation of the prostate (HoLEP) are established surgical treatments for BPH.
• Understanding the economic impact of different surgical approaches is crucial for healthcare management.

Purpose of the Study:

• To compare the hospital-based direct costs of care for BPH patients undergoing OSP versus HoLEP.
• To identify the primary drivers of cost differences between these two surgical procedures.

Main Methods:

• Retrospective analysis of hospital billing data and medical records.
• Inclusion of direct costs: personnel, facilities, equipment, consumables, and medications.
• Cost data converted to USD using official exchange rates.

Main Results:

• Fifty patients were analyzed (25 OSP, 25 HoLEP) with comparable demographics and prostate volumes.
• OSP patients experienced longer hospital stays and higher ICU admission rates, leading to significantly higher total direct costs (USD 4,676 vs. USD 3,360; p < 0.001).
• HoLEP had higher initial procedural costs but resulted in lower overall hospital costs.

Conclusions:

• HoLEP is associated with lower short-term hospital-based direct costs compared to OSP.
• Reduced postoperative resource utilization is the main factor contributing to HoLEP's cost-effectiveness.
• These findings offer valuable economic data for healthcare institutions when selecting BPH surgical treatments.