Dr. David Lee on cost analysis for same-day discharge after RARP

In this video, David I. Lee, MD, FACS, discusses the AUA 2024 abstract, “Cost analysis of inpatient vs same-day discharge pathway for robot-assisted radical prostatectomy.” Lee is director of the UCI Health Comprehensive Prostate Cancer Program and professor of urology at the UCI School of Medicine.

Transcription:

Please give an overview of the AUA 2024 presentation "Cost analysis of inpatient vs same-day discharge pathway for robot-assisted radical prostatectomy."

In conjunction with patient perspective on what they felt like, and how they did after they were discharged the same day, one of the other really interesting topics is what happens to hospital reimbursement. There are some physicians and health care providers who feel like this is something that hospitals would push a lot in order to get patients home the same day because their revenue percentage may go up because you're shrinking health care costs, but the hospital would be getting similar reimbursement. And so we looked at our experience, to see if there was a correlation in both payment and health care costs. And so in our analysis of looking at different payer providers and our real-world experience of what we got from a health care system provider perspective, we were able to see that we did cut costs in about half as opposed to patients staying overnight, but the revenue that the hospital received was also cut. And so the hospital would actually do a lot better if patients stayed overnight, as far as their overall revenue and the revenue vs costs. But I think it really depends a lot on your hospital system and how they're doing. At UCI, we're always short on inpatient beds, because we have a lot of patients coming to the emergency room. We're very busy in our operating room among all the different specialties. And so this creates a situation where we're always looking for more inpatient beds. And then so from our health care systems perspective, they want our patients to go home sooner, not because they'll make more money that way, but we can offer the care that patients need from our local community with all the health care problems that they're having. And so this creates a really nice balance for us to be able to send our patients home the same day. But if there's another hospital system where their hospital isn't all that full, then it might make sense for patients to then stay overnight, but it's something that works really well for us at UCI.

This transcription was edited for clarity.