2025-02-252021-04-06https://repositorio.cmmg.edu.br/handle/123456789/82INTRODUCTION: High costs of robot-assisted radical prostatectomy (RARP) represent a major drawback of this technology. Considering the financial impact arising from new health care technologies, it is essential to improve the knowledge of factors that influence costs. OBJECTIVE: This study aimed to evaluate the main drivers of RARP hospitalization costs, in addition to assess the relation between clinical, pathological, intraoperative and postoperative variables and the hospitalization costs. MATERIALS AND METHODS: Cross-sectional study of a single private healthcare institution, in which 474 hospitalizations related to RARP between February 2018 and December 2019 were analyzed. Clinical, pathological, intraoperative and postoperative characteristics were considered in the study, including surgical experience. The association between variables and total direct costs was analyzed by simple and multiple linear regression. RESULTS: The main driver of RARP hospitalization costs was the robotic surgical supplies (60.5%), followed by the operation room (OR) time (15.2%). Procedures performed by surgeons with 15 or more cases of surgical experience were associated with a 6.9% decrease in costs in simple linear regression analysis. In multiple linear regression analysis, the following variables were associated with increased costs: American Society of Anesthesiologists (ASA) score 3 (p< 0.001), a one-hour increase in OR time (p < 0.001), increased utilization of polymeric clips packs (p < 0.001), longer length of hospital stay (p< 0.001) and. There was a 11.5% reduction in costs with the use of four robotic instruments instead of five (p < 0.001). CONCLUSIONS: Among clinical and pathological characteristics, only the severity of comorbidities was associated with hospitalization costs. Surgical experience may have an important role in reducing costs. The costs of hospitalization were mainly influenced by the OR time, use of surgical supplies and length of hospital stay. Reducing the number of robotic instruments used in RARP represented the potentially modifiable factor with the greatest impact on cost reduction.Acesso abertoCustos e Análise de Custo, Custos Hospitalares, Procedimentos Cirúrgicos Robóticos, Prostatectomia, Câncer de próstata; Costs and Cost Analysis, Hospital Costs, Robotic Surgical Procedures, Prostatectomy, Prostate cancer.Dissertação4.01.00.00-6 - Medicina