The clinical and financial implications of a decade of prostate biopsies in the NHS - interrogation of the Hospital Episode Statistics (HES) Data 2008-2019
BAUS ePoster online library. Vasdev N. 11/10/20; 304141; P9-7
Mr. Nikhil Vasdev
Mr. Nikhil Vasdev
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The clinical and financial implications of a decade of prostate biopsies in the NHS - interrogation of the Hospital Episode Statistics (HES) Data 2008-2019

Tamhankar A1, El Taji O1, Vasdev N1, Foley C1, Popert R2, Adshead J1
1Lister Hospital, Stevenage, United Kingdom, 2Guys Hospital, London, United Kingdon

Introduction:
To date, the evidence for comparing transrectal (TR) and transperineal (TP) route of prostate biopsy has not been consolidated especially in antibiotic resistance era.

Methods:
This is an interrogation of national Hospital Episode Statistics, to evaluate the clinical and financial implications of a decade (2008-2019) of prostate biopsies in the United Kingdom National Health Scheme for assessment of 28 days complications and non-elective readmissions (NEL) with secondary evaluation of cost implications.
Findings: Out of 486,467 biopsies (387,879 TR and 98,588 TP), rates for infection and sepsis were higher for TR cohort (p<0.001). Sepsis has been more than doubled for TR biopsies in last two years than the decade (1.12% Vs 0.53%). Predominant reasons for NEL for TR and TP cohorts were infection and urinary retention respectively and in last two years NEL rate was lesser for TP group (3.54% Vs 3.74%). The estimated expenditures for NEL for the decade were £33,589,527 and £7,179,926 respectively for TR and TP cohorts (p<0.001), translating into per patient cost of £2,225 and £1,758 respectively (p<0.001). Assuming that all the biopsies were done transperineally, downstream savings for managing NEL would have been £7,501,655 with added upstream savings of approximately £60,909,959 if done under local anaesthetic (LA).
Future implications: The data gives sufficient evidence for the distinct advantages of TP over TR route in terms of lesser infections and burden of expenditure with a potential for saving both upstream and downstream costs, attributing to the decision of shifting the practice pattern towards LATP route.
The clinical and financial implications of a decade of prostate biopsies in the NHS - interrogation of the Hospital Episode Statistics (HES) Data 2008-2019

Tamhankar A1, El Taji O1, Vasdev N1, Foley C1, Popert R2, Adshead J1
1Lister Hospital, Stevenage, United Kingdom, 2Guys Hospital, London, United Kingdon

Introduction:
To date, the evidence for comparing transrectal (TR) and transperineal (TP) route of prostate biopsy has not been consolidated especially in antibiotic resistance era.

Methods:
This is an interrogation of national Hospital Episode Statistics, to evaluate the clinical and financial implications of a decade (2008-2019) of prostate biopsies in the United Kingdom National Health Scheme for assessment of 28 days complications and non-elective readmissions (NEL) with secondary evaluation of cost implications.
Findings: Out of 486,467 biopsies (387,879 TR and 98,588 TP), rates for infection and sepsis were higher for TR cohort (p<0.001). Sepsis has been more than doubled for TR biopsies in last two years than the decade (1.12% Vs 0.53%). Predominant reasons for NEL for TR and TP cohorts were infection and urinary retention respectively and in last two years NEL rate was lesser for TP group (3.54% Vs 3.74%). The estimated expenditures for NEL for the decade were £33,589,527 and £7,179,926 respectively for TR and TP cohorts (p<0.001), translating into per patient cost of £2,225 and £1,758 respectively (p<0.001). Assuming that all the biopsies were done transperineally, downstream savings for managing NEL would have been £7,501,655 with added upstream savings of approximately £60,909,959 if done under local anaesthetic (LA).
Future implications: The data gives sufficient evidence for the distinct advantages of TP over TR route in terms of lesser infections and burden of expenditure with a potential for saving both upstream and downstream costs, attributing to the decision of shifting the practice pattern towards LATP route.
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