Cost-benefit performance of robotic surgery compared with video-assisted thoracoscopic surgery under the Japanese national health insurance system

Naohiro Kajiwara, James Patrick Barron, Yasufumi Kato, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Background: Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci<sup>®</sup> Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). Objective: To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. Methods: This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. Results: The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Conclusion: Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

    Original languageEnglish
    Pages (from-to)95-101
    Number of pages7
    JournalAnnals of Thoracic and Cardiovascular Surgery
    Volume21
    Issue number2
    DOIs
    Publication statusPublished - 2015

    Fingerprint

    Video-Assisted Thoracic Surgery
    National Health Programs
    Robotics
    Medical Fees
    Cost-Benefit Analysis
    Thoracic Surgery
    Surgical Equipment
    Health Insurance Reimbursement
    Medical Economics
    Explosions
    Japan
    Costs and Cost Analysis

    Keywords

    • Cost-benefit performance
    • Japanese national health insurance system
    • Robotic surgery

    ASJC Scopus subject areas

    • Surgery
    • Cardiology and Cardiovascular Medicine
    • Pulmonary and Respiratory Medicine
    • Gastroenterology

    Cite this

    Cost-benefit performance of robotic surgery compared with video-assisted thoracoscopic surgery under the Japanese national health insurance system. / Kajiwara, Naohiro; Barron, James Patrick; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko.

    In: Annals of Thoracic and Cardiovascular Surgery, Vol. 21, No. 2, 2015, p. 95-101.

    Research output: Contribution to journalArticle

    Kajiwara, Naohiro ; Barron, James Patrick ; Kato, Yasufumi ; Kakihana, Masatoshi ; Ohira, Tatsuo ; Kawate, Norihiko ; Ikeda, Norihiko. / Cost-benefit performance of robotic surgery compared with video-assisted thoracoscopic surgery under the Japanese national health insurance system. In: Annals of Thoracic and Cardiovascular Surgery. 2015 ; Vol. 21, No. 2. pp. 95-101.
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