Pd08-11 Transitioning to Outpatient Clinic Transperineal Prostate Biopsy: Saving Money, Theatre Space and Lives

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes I (PD08)1 May 2024PD08-11 TRANSITIONING TO OUTPATIENT CLINIC TRANSPERINEAL PROSTATE BIOPSY: SAVING MONEY, THEATRE SPACE AND LIVES Ali Hooshyari, David Scholtz, Keu Maoate, Mark Fraundorfer, Peter Gilling, Wikus Vermeulen, and Flavio Ordones Ali HooshyariAli Hooshyari , David ScholtzDavid Scholtz , Keu MaoateKeu Maoate , Mark FraundorferMark Fraundorfer , Peter GillingPeter Gilling , Wikus VermeulenWikus Vermeulen , and Flavio OrdonesFlavio Ordones View All Author Informationhttps://doi.org/10.1097/01.JU.0001008576.33217.96.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy (TPPB) is the gold standard diagnostic tool for detection of prostate cancer. Compared to traditional transrectal biopsy (TRUS), TPPB is superior in its ability to sample apical and anterior areas without the associated risks of urinary tract infection or sepsis. In many centers, these biopsies are still performed under general anaesthetic (GA) in the operating theatre (OT). We highlight the cost, time and resource effectiveness realized in the transition to TPPB under local anaesthetic (LA) in outpatient clinic (OPC) in our institution. METHODS: We retrospectively reviewed our hospital's business intelligence records and collected cost breakdown data for TPPB in OT and OPC. The average cost per biopsy was calculated using this data. We looked at the number of theatre lists and cases performed over a 12-month period and performed a head-to-head analysis comparing the differential costs and realized cost savings in $NZD (RCS). To further assess the financial gain of our move to TPPB, we gathered cost data for hospital admissions of patients presenting with TRUS-related sepsis. RESULTS: The average cost per patient for TPPB under GA in OT was $4220 compared to $1400 for TPPB under LA in OPC. Our theatre records for 2019 and 2020 show that on average 9 TPPBs were performed under GA in OT per list. With one list per month and 108 cases annually, the cost was $453,600 per year. If the same number of TPPBs are performed annually under LA in OPC, the cost would be $151,200 with a RCS of $302,400. Over a 12-month period from April 2022-2023, 208 TPPB were performed under LA in OPC with a total cost of $291,200. Over a 12-month period from March 2021-2022, 7 patients were admitted to our hospital for TRUS sepsis with a total cost of $27,235, an average of $3,890 per patient and a mean length of stay of 86 hrs. CONCLUSIONS: The cost of TPPB is reduced 3x by moving our biopsies to OPC under LA and for the same number of cases saves over $300,000 per year. The move allows for double the number of TPPBs to be performed annually, which despite the dramatic increase in cases still carries a 1.5x cost reduction. Approximately 12 full-day theatre lists are made available per year as a result of this transition. The transition has also allowed us to stop performing TRUS biopsies and as a result we have reduced prostate-biopsy related sepsis, improved patient outcomes and improved antimicrobial stewardship. In summary, this study demonstrates that phasing out TRUS and transitioning to TPPB under LA in OPC is a cost-effective, safe, resource-preserving and space-generating change. Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e177 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ali Hooshyari More articles by this author David Scholtz More articles by this author Keu Maoate More articles by this author Mark Fraundorfer More articles by this author Peter Gilling More articles by this author Wikus Vermeulen More articles by this author Flavio Ordones More articles by this author Expand All Advertisement PDF downloadLoading ...