Comparison of Cost and Reimbursement Between Abdominal and Robotic Sacrocolpopexy

Objectives: Our study aims to compare cost and reimbursement of robotic and abdominal sacrocolpopexy procedures to evaluate which may be more cost-efficient.

Methods: We performed a retrospective cohort study investigating all patients who underwent robotic or abdominal sacrocolpopexy at our hospital between July 1, 2018 and May 31,2022. Patient demographic, procedural, and post-operative course data were extracted via chart review including duration of procedure, time in operating room, complications, and length of hospital stay. The billing department provided information on estimated cost of stay and reimbursement rates.

Results: A total of 203 robotic and 291 abdominal cases were included in analysis. The groups had significant differences in demographics, including race and insurance status. Abdominal procedures were associated with lower costs and higher reimbursement rates, as shown in Figure 1, with the total collected (reimbursement minus cost) differing significantly at $1354.80 for robotic versus $8534.50 for abdominal sacrocolpopexy procedures. These discrepancies remained after controlling for secondary procedures, such as colporrhaphy or sling, demonstrated in Figure 2. Abdominal cases also had shorter average duration (129.9 vs. 168.4 minutes, p< 0.0001). Abdominal sacrocolpopexy was associated with higher estimated blood loss (EBL) (109.2 vs. 97.9, p< 0.0001) and longer hospital stay (26.3 versus 15.9 hours, p< 0.0001).

Conclusions: Despite longer hospital stays and slightly higher EBL, abdominal sacrocolpopexy appears to be more cost-effective than robotic sacrocolpopexy, with lower hospital stay costs and higher reimbursement rates.