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Average charges for a radical prostatectomy and a transurethral resection of the prostate (TURP): geographic
Insights
Prostate surgery costs, including radical prostatectomy and transurethral resection of the prostate (TURP), varied significantly by geographic region and state in 1994. Significant cost disparities existed for these common procedures.
Area of Science:
- Urology
- Health Economics
- Public Health
Background:
- Radical prostatectomy and transurethral resection of the prostate (TURP) are common urological procedures.
- Significant variations in healthcare costs exist within the United States.
Purpose of the Study:
- To analyze geographic variations in hospital and physician charges for radical prostatectomies and TURPs.
- To identify regional and state-level cost differences for these procedures.
Main Methods:
- Analysis of 1994 claims data from MetLife group health policies.
- Examination of charges for 1,004 radical prostatectomies and 1,597 TURPs.
- Comparison of average total charges, physician fees, and lengths of stay across different geographic areas and states.
Main Results:
- The Pacific area had the highest total charge for radical prostatectomy ($20,790), while the East South Central area had the lowest.
- The South Atlantic area reported the highest average TURP charges ($8,710), with the East South Central area reporting the lowest.
- Physician fees for both procedures showed over 95% variation between states, with New York being the most expensive.
- Hospital lengths of stay also varied, with New York having the longest for radical prostatectomy and Indiana for TURP.
Conclusions:
- Geographic variations in healthcare costs for radical prostatectomies and TURPs were substantial in 1994.
- These findings highlight significant regional disparities in healthcare spending for common urological procedures.
- Understanding these cost variations is crucial for healthcare policy and resource allocation.
Abstract:
In 1994 MetLife paid claims from group health policy insured for 1,004 radical prostatectomies and 1,597 transurethral resections of the prostate (TURPs). The total average hospital and physician charges were $18,680 and $7,600, respectively, with marked geographic variation evident for both procedures by area and state. The Pacific area led with a total charge of $20,790 for a radical prostatectomy, 11.3 percent above the U.S. average and the South Atlantic area reported the highest average TURP charges, $8,710 (14.6 percent above norm). For both surgeries, the East South Central area reported the lowest average total charge, 21.2 percent lower than the norm for a TURP and 30.9 percent lower than the national prostatectomy average. Charges 20 percent or more above the national average were reported in Illinois, California, Georgia and North Carolina for a TURP and in Illinois, California and Pennsylvania for a radical prostatectomy. Of the study states, Tennessee, Washington, Michigan and Oklahoma had charges 20 percent or more below the national average for a prostatectomy; Washington, Ohio, Tennessee, Alabama and Oregon each had average TURP charges 25 percent or more below the U.S. average. Physician fees differed by more than 95 percent between New York ($3,240) and Michigan ($1,660) for a TURP and by 113 percent between the doctors' charges for a prostatectomy in New York ($8,710) and those in Tennessee ($4,080). On average, patients remained in the hospital for 5.56 days for the radical procedure with lengths of stay ranging from 7.02 days in New York to 4.42 days in Missouri. TURP patients were in the hospital for an average of 3.66 days with Indiana patients staying the longest (5.58 days) and those in Oregon the shortest (2.29 days).