Faaliyet Tabanlı Maliyetleme Yöntemine Göre; Robot Yardımlı ve Laparoskopik Radikal Prostatektomi Ameliyatlarının Perioperatif Maliyetlerinin ve Sağlık Sonuçlarının Karşılaştırılması: Bir Üniversite Hastanesi Örneği

Abstract

Increasing health expenditures and health care costs with technological developments are among the current debates. Health services is one of the sectors that closely follows technological developments and attracts attention with its increasing investment costs. The main purpose of the research is to determine the unit and total costs, quality of life and health outcomes of radical prostatectomy surgery (laparoscopic and robotic) methods. Within the scope of the research, data obtained from 181 patients who had prostatectomy surgery in a university hospital serving in Ankara were evaluated. The study also aimed to directly determine what affects the choice of surgery type, and also collected data on common quality of life (EORTC QLQ-30), symptoms (IPSS) and pain (VAS) symptoms. Activity Based Costing method was used to determine the cost amounts in the research. As a result of the analysis; The average unit surgical cost of laparoscopic surgery was determined as 9,832.17 (±2,778.46) TL and the average perioperative cost was determined as 22,722.85 (±8,717.23) TL. The average unit surgical cost of robotic surgery was calculated as 60,426.56 (±9,260.05) TL and the average perioperative cost was calculated as 72,081.06 (±10,838.46) TL. It was also determined that laparoscopic solutions were more available in the outpatient clinic and resources for clinical and postoperative support services were used more. The impact of patient-related socio-demographic characteristics and characteristics related to patients' use of healthcare services on patients' health-related quality of life and clinical outcomes (hospitalization time, surgery time and catheter stay time) and treatment costs (outpatient clinic, clinic, operating room, clinical support and perioperative); The effect of clinical outcomes for patients (blood transfusion and readmission status, hospitalization, surgery and catheter stay time) on costs (outpatient clinic, clinic, operating room, clinical support and perioperative) was tested. Based on these results, regulations regarding service costs and hospital cost structuring were suggested to macro and micro level managers.