Percutaneous nephrostolithotomy

An assessment of costs for prone and galdakao-modified supine valdivia positioning

Justin I. Friedlander, Brian Duty, Arthur D. Smith, Zeph Okeke

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To examine the relative costs of prone percutaneous nephrostolithotomy (PCNL) versus PCNL performed with the patient in the Galdakao-modified supine Valdivia (GMSV) position to determine whether a cost differential exists. Methods: We compared prone PCNL with PCNL using GMSV positioning. Cost data were obtained from the urology departmental and hospital billing offices at our institution and from the 2011 local Medicare reimbursement scales. The costs were divided into 5 major categories: surgeon fees, anesthesia fees, surgical supplies, hospital-related fees, and lost revenue. Results: The overall cost of prone PCNL ranged from $23 423 to $24 463, and the cost for PCNL performed with GMSV positioning ranged from $24 725 to $25 830. The difference between the 2 positions ranged from approximately $1302 for stones ≤2 cm to $1367 for stones >2 cm. The lost office revenue because of the requirement for a second surgeon was estimated at $1987. Conclusion: Our assessment of the cost for prone versus GMSV PCNL technique found GMSV positioning to be more costly. The presence of 2 surgeons was the main driver of the cost differential, because it resulted in more equipment use, with greater instrument repair costs and higher surgeon fees. It also brings into consideration the opportunity cost of having a second surgeon in the operating room and not in the office.

Original languageEnglish (US)
Pages (from-to)771-775
Number of pages5
JournalUrology
Volume80
Issue number4
DOIs
StatePublished - Oct 2012
Externally publishedYes

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Costs and Cost Analysis
Fees and Charges
Hospital Equipment and Supplies
Supine Position
Urology
Operating Rooms
Medicare
Anesthesia
Surgeons
Equipment and Supplies

ASJC Scopus subject areas

  • Urology

Cite this

Percutaneous nephrostolithotomy : An assessment of costs for prone and galdakao-modified supine valdivia positioning. / Friedlander, Justin I.; Duty, Brian; Smith, Arthur D.; Okeke, Zeph.

In: Urology, Vol. 80, No. 4, 10.2012, p. 771-775.

Research output: Contribution to journalArticle

Friedlander, Justin I. ; Duty, Brian ; Smith, Arthur D. ; Okeke, Zeph. / Percutaneous nephrostolithotomy : An assessment of costs for prone and galdakao-modified supine valdivia positioning. In: Urology. 2012 ; Vol. 80, No. 4. pp. 771-775.
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