• Latest
  • Trending
  • All
  • Featured Urology
  • Female Urology
  • Urologic Oncology
  • What is Urology?
  • Pediatric Urology
  • Urology

‘Pay-for-performance’ may lead to higher risk for robotic prostate surgery patients

September 8, 2020
Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

November 14, 2022
New treatment can more than double life expectancy for people with prostate cancer: doctor

New treatment can more than double life expectancy for people with prostate cancer

November 14, 2022
Study finds that use of yoga app can reduce urinary incontinence

Study finds that use of yoga app can reduce urinary incontinence

November 9, 2022
Urinary Incontinence: Types and Treatments

Urinary Incontinence: Types and Treatments

November 9, 2022
Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

November 4, 2022
Can Erectile Dysfunction Drugs Reduce Dementia Risk?

Can Erectile Dysfunction Drugs Reduce Dementia Risk?

November 4, 2022
New PSA test examines protein structures to detect prostate cancers

New PSA test examines protein structures to detect prostate cancers

November 2, 2022
A better way to image metastatic prostate cancer

A better way to image metastatic prostate cancer

November 2, 2022
Newly discovered protein may protect kidney cells from injury

Newly discovered protein may protect kidney cells from injury

November 2, 2022
A person’s diet, acidity of urine may affect susceptibility to UTIs

A person’s diet, acidity of urine may affect susceptibility to UTIs

November 2, 2022
Award-winning agent developed for prostate cancer diagnosis and treatment

Award-winning agent developed for prostate cancer diagnosis and treatment

November 2, 2022
New treatment for polycystic kidney disease

New treatment for polycystic kidney disease

November 2, 2022
Tuesday, November 15, 2022
Urology Today
  • Home
  • Featured Urology
    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Study finds that use of yoga app can reduce urinary incontinence

    Study finds that use of yoga app can reduce urinary incontinence

    Urinary Incontinence: Types and Treatments

    Urinary Incontinence: Types and Treatments

    Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

    Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

    Kidney failure impacts survival of sepsis patients

    Kidney failure impacts survival of sepsis patients

    Urine-based test improves on PSA for detecting prostate cancer

    Urine-based test improves on PSA for detecting prostate cancer

    Unemployment linked to rise in prostate cancer deaths

    Unemployment linked to rise in prostate cancer deaths

    Unemployment linked to rise in prostate cancer deaths

    Advanced viral gene therapy eradicates prostate cancer in preclinical experiments

    prostate cancer

    Recurrence of prostate cancer detected earlier with innovative PSMA-ligand PET/CT

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Trending Tags

    • Donald Trump
    • Future of News
    • Climate Change
    • Market Stories
    • Election Results
    • Flat Earth
  • Lifestyle
    • All
    • Female Urology
    • Male Urology
    • Pediatric Urology
    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

    Study finds that use of yoga app can reduce urinary incontinence

    Study finds that use of yoga app can reduce urinary incontinence

    Urinary Incontinence: Types and Treatments

    Urinary Incontinence: Types and Treatments

    New PSA test examines protein structures to detect prostate cancers

    New PSA test examines protein structures to detect prostate cancers

    A better way to image metastatic prostate cancer

    A better way to image metastatic prostate cancer

    Award-winning agent developed for prostate cancer diagnosis and treatment

    Award-winning agent developed for prostate cancer diagnosis and treatment

    New treatment for polycystic kidney disease

    New treatment for polycystic kidney disease

    Urine-based test improves on PSA for detecting prostate cancer

    Urine-based test improves on PSA for detecting prostate cancer

    Unemployment linked to rise in prostate cancer deaths

    Advanced viral gene therapy eradicates prostate cancer in preclinical experiments

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Two major studies strengthen case for prostate cancer drug before chemotherapy

    Trending Tags

    • Golden Globes
    • Mr. Robot
    • MotoGP 2017
    • Climate Change
    • Flat Earth
No Result
View All Result
Urology Today
No Result
View All Result
Home Urology / Nephrology News

‘Pay-for-performance’ may lead to higher risk for robotic prostate surgery patients

by Urology Today
September 8, 2020
in Urology / Nephrology News
0
491
SHARES
1.4k
VIEWS
Share on FacebookShare on Twitter

A “perverse disincentive” for hospitals that have invested in expensive technology for robotic surgery may be jeopardizing prostate cancer patients who seek out the procedure, concluded a new study led by Henry Ford Hospital researchers.

The study, which compared complication rates in hospitals with low volumes of robot-assisted radical prostatectomies (RARPs) to institutions with high volumes of the procedure, suggested that current pay-for-performance healthcare models are to blame.

The new study was published online this month by BJU International.

“Patients pursue robotic surgery based on perceived benefit, including its minimally invasive nature and faster recovery time compared to conventional open surgery,” says Jesse Sammon, D.O., a researcher at Henry Ford’s Vattikuti Urology Institute and lead author of the study. “But they fail to take into account the importance of hospital and surgeon experience on outcomes.”

Now the most common surgical method for treating prostate cancer in the U.S., RARP allows a surgeon to remove the diseased prostate by manipulating robotic arms holding undersized instruments through tiny incisions in the patient’s skin.

Besides avoiding the higher risk of infection and blood loss posed by open surgery, successful RARP reduces patient hospital stay and recovery time.

Researchers at Henry Ford Hospital, a pioneer in robotic surgery that has now performed more than 10,000 RARPs, saw a rapid increase in U.S. hospitals investing in the technology and performing the procedure during the past decade.

Building on earlier research that showed higher-volume hospitals had more success with the procedure than smaller institutions, the new study focused on all patients listed in the National Inpatient Sample (NIS) who underwent RARP between 2009 and 2011. The NIS collects and provides data on all patients discharged from a 20 percent sample of non-federal hospitals in the U.S.

Researchers also collected the number of RARPs performed at the hospitals where the patients were treated, categorized the hospitals according to that volume and recorded the complication rates for each.

They found:

  The number of hospitals performing RARP remained stable over the study period – 802 in 2009, 792 in 2010 and 808 in 2011.
  The overall complication rate after surgery was “significantly” related to the volume of RARPs performed at a hospital.
  14.7 percent of patients treated at very-low volume institutions experienced complications while those treated at very-high volume institutions experienced a complication rate of 5.7 percent.
  Patients treated at very-high volume hospitals were less than half as likely to experience a complication as those treated at very-low volume hospitals.

In presenting the study, researchers noted that during the 1990s when centralizing surgical treatment for cancers of the bladder and kidney resulted in a greater percentage of cases being sent to high-volume hospitals, the same was not true for prostate cancers during that decade.

“But between 2000 and 2008,” Dr. Sammon explains, “there was a 74 percent increase in the number of radical prostatectomies performed, and a 19 percent decrease in the number of hospitals performing radical prostatectomy.

“By 2009, the median hospital volume for open radical prostate surgery was 32 cases per year compared to 137 cases per year using the robotic approach.”

What this suggests, Sammon says, is that “market forces” behind the adoption of robotic surgery may have unintentionally had the salutary effect of centralizing prostate cancer care.

Yet the new study suggests that, with the boom in robotic surgery, fewer patients are seeking care at very-high volume hospitals, instead choosing low-volume institutions that have invested in the technology but have less experience in using it – and may be placing themselves at higher risk of complications.

“This migration of patients away from very-high volume hospitals is likely the result of the current pay-for-performance models in U.S. healthcare,” Dr. Sammon says. “For institutions that have invested millions in robotic technology, this removes the incentive to refer patients to other, higher volume hospitals.

“This perverse disincentive is probably jeopardizing patients, and calls for a renewed focus on the benefits of centralized care at larger providers.”

###

The research was conducted by Vattikuti Urology Institute, Center for Outcomes Research Analytics & Evaluation, Henry Ford Health System and the Center for Surgery and Public Health and Division of Urologic Surgery, Brigham & Women’s Hospital, Harvard Medical School.

###

Dwight Angell
.(JavaScript must be enabled to view this email address)
313-876-8709

Henry Ford Health System

Journal
  BJU International

Share196Tweet123Share49
Urology Today

Urology Today

  • Trending
  • Comments
  • Latest
Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

Low Rates of PSA Screening Linked to Increase in Metastatic Prostate Cancer

November 4, 2022
Embryogenesis -Paediatric Urology

Embryogenesis -Paediatric Urology

November 2, 2022

Urethral pressure profilometry

September 8, 2020

Genetic basis of genitourinary malformations

0
Embryogenesis -Paediatric Urology

Embryogenesis -Paediatric Urology

0
Upper urinary tract

Upper urinary tract

0
Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

Yoga for Prostate Cancer: Best Yoga exercises to combat prostate growth in men

November 14, 2022
New treatment can more than double life expectancy for people with prostate cancer: doctor

New treatment can more than double life expectancy for people with prostate cancer

November 14, 2022
Study finds that use of yoga app can reduce urinary incontinence

Study finds that use of yoga app can reduce urinary incontinence

November 9, 2022
Urology Today

Copyright © 2022 Urology Today.

Navigate Site

  • About
  • Advertise
  • Privacy & Policy
  • Contact

Follow Us

No Result
View All Result
  • Home
  • Featured Urology
    • Urologic Oncology
    • Female Urology
    • Pediatric Urology
    • What is Urology?
  • Lifestyle

Copyright © 2022 Urology Today.

Welcome Back!

Login to your account below

Forgotten Password?

Retrieve your password

Please enter your username or email address to reset your password.

Log In