Clinical outcomes associated with the implementation of a cost-efficient programme for radical retropubic prostatectomy


Vanderbilt University Medical Center, Department of Urology, D-4314 Medical Center North, Nashville, Tennessee 37232–2765, USA.


Objective To develop and analyse a cost-containment programme for radical retropubic prostatectomy.

Patients and methods An in-depth analysis of the hospital charges associated with radical retropubic prostatectomy was conducted and a standard programme developed to control patient costs using a collaborative pathway method. The development of this programme and the outcomes of the first 50 patients who underwent radical retropubic prostatectomy while on the collaborative care pathway system are summarized.

Results The programme reduced both overall hospital charges per patient and the duration of hospital stay by 44%. In addition, there was a significant reduction in the duration of surgery, intra-operative blood loss and the need for transfusion. Implementation of this programme had no apparent adverse effects on the rates of major or minor complications or hospital re-admissions, and was accepted well by the patients.

Conclusion The collaborative care pathway developed for radical prostatectomy provides a system to deliver high quality, cost-efficient care in an environment which is highly acceptable to patients and which allows continued refinements in the care delivered.