Budget Impact of an Ambulatory Minimally Invasive Surgical Treatment in an Italian Public Hospital
Author(s)
David Piccolotti, MD1, Giorgio Buseghin, MSc2, Giovanni Carriero, MSc3.
1Ospedali Riuniti Padova Sud ULSS6 Euganea, Monselice, Italy, 2Olympus Europa SE & Co. KG, Hamburg, Germany, 3Access 4 Pharma, Milan, Italy.
1Ospedali Riuniti Padova Sud ULSS6 Euganea, Monselice, Italy, 2Olympus Europa SE & Co. KG, Hamburg, Germany, 3Access 4 Pharma, Milan, Italy.
OBJECTIVES: With the growing number of men suffering Lower Urinary Tract Symptoms (LUTS) secondary to benign prostatic obstruction (BPO), Italian public hospitals are facing several challenges: increasingly long waiting lists, extended hospital stays, and prolonged operating room (OR) occupation, limiting the resources available for more urgent cases. These issues could be significantly reduced by offering patients minimally invasive surgical treatments (MISTs) in an outpatient setting.
METHODS: An Excel-based budget impact model with a 5-year time horizon and public hospital perspective was developed to model the impact of converting a casemix of procedures in the OR to a MIST in the outpatient setting. Either transurethral prostate incision (TUIP) or the temporary implanted nitinol device (temporary device) were performed in the OR, but only the temporary device was performed in outpatients.
RESULTS: In the current scenario, 45 temporary device procedures are performed as day surgeries and 20 TUIP procedures as inpatient surgeries. The total OR usage amounts to 59 hours, with surgeons, anesthesiologists and nurses engaged for a combined total of 453 hours, and a cumulative hospital stay of 65 days. In the projected future scenario, 65 temporary device procedures are carried out in an outpatient setting, eliminating OR occupation entirely (100% reduction), significantly decreasing the time required from medical staff (21% reduction), and reducing hospital stay by 100%. The economic impact of utilizing ambulatory facilities instead of the OR and inpatient beds, translates into a saving of 25,200 Euros over a five-year horizon.
CONCLUSIONS: Utilising the ambulatory setting to perform the temporary implanted nitinol device, as an alternative to OR-based procedures like TUIP or the same procedure under general anesthesia, helps free up surgical capacity while still treating BPO patients on the waiting list. This approach not only improves the efficiency of hospital resource utilization but also results in direct cost savings.
METHODS: An Excel-based budget impact model with a 5-year time horizon and public hospital perspective was developed to model the impact of converting a casemix of procedures in the OR to a MIST in the outpatient setting. Either transurethral prostate incision (TUIP) or the temporary implanted nitinol device (temporary device) were performed in the OR, but only the temporary device was performed in outpatients.
RESULTS: In the current scenario, 45 temporary device procedures are performed as day surgeries and 20 TUIP procedures as inpatient surgeries. The total OR usage amounts to 59 hours, with surgeons, anesthesiologists and nurses engaged for a combined total of 453 hours, and a cumulative hospital stay of 65 days. In the projected future scenario, 65 temporary device procedures are carried out in an outpatient setting, eliminating OR occupation entirely (100% reduction), significantly decreasing the time required from medical staff (21% reduction), and reducing hospital stay by 100%. The economic impact of utilizing ambulatory facilities instead of the OR and inpatient beds, translates into a saving of 25,200 Euros over a five-year horizon.
CONCLUSIONS: Utilising the ambulatory setting to perform the temporary implanted nitinol device, as an alternative to OR-based procedures like TUIP or the same procedure under general anesthesia, helps free up surgical capacity while still treating BPO patients on the waiting list. This approach not only improves the efficiency of hospital resource utilization but also results in direct cost savings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE104
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Reproductive & Sexual Health