The blogger known only as the Skeptical Scalpel (self-described as a surgeon for 40 years and a surgical department chairman and residency program director for over 23 of those years) continues his thread of posts raising questions about the proliferation of robotic surgery.
The latest is entitled “Study: Robotic surgery financials explained.” It’s his take on a paper presented at the annual meeting of the American Association of Gynecologic Laparoscopists. Excerpts:
The headline, Robotic Hysterectomy Cuts Blood Loss in Obese, is certainly catchy. Lets look deeper.
The lead author said, The robotic hysterectomy does offer lower rates of conversion to laparotomy but does cause higher facility and total charges, as well as higher reimbursement rates. The mean total hospital charge for robotic hysterectomy was $44,700 versus $25,557, a statistically significant difference. The average charge for the robotic instruments was $8,322 compared to $3,762 for standard laparoscopy equipment, also a significant difference. In response to a question about why there was such a disparity, the lead author said: The charges are likely to recoup the cost of the robot purchase. We have multiple robots four at our main institution and several others at other sites.
The reimbursement actually received for robotic hysterectomy was $19,000 and for standard laparoscopic, a mere $$8,000.
I congratulate the authors for their candor [though no doubt inadvertent] in sharing the financial data and the reasons why robotic surgery is more costly. I am gobsmacked* at the differential in charges and reimbursement for the two types of hysterectomy and that the secret would be so openly shared.
I guess someone has to help the hospital recoup the cost of the robot purchase. But I wonder why third party payers are shelling out almost two-and-a half times more money for a procedure that has not been proven more effective than standard laparoscopic surgery?
And you wonder why health care costs are skyrocketing?