Abstract

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• INTRODUCTION:

  To assess whether urologists are able to accurately estimate the cost of commonly used endourologic disposable devices.

  MATERIALS AND METHODS:

  An anonymous questionnaire was presented to resident and attending urologists in one academic healthcare system. Respondents estimated the cost of 15 disposable devices commonly used in ureteroscopy. Twenty-five surgeons (9 resident and 16 attending urologists) participated for a response rate of 96.2%. Respondents' cost estimates were compared to actual institutional costs and considered accurate if the absolute percentage error was within 20%. Additional information obtained included: years in practice, participation in purchasing activities, practice setting, number of ureteroscopy procedures performed monthly, degree of confidence in ability to estimate cost, and the importance of cost in device selection for each respondent.

  RESULTS:

  Of 375 total responses, 62 (16.5%) were accurate, 308 (82.1%) were inaccurate, and 5 (1.3%) were unanswered. The mean percentage error (MPE) for all responses was 178.8% (IQR 35.1%-211.4%). Overall, 73% of responses were overestimations and 27% were underestimations. Residents had an MPE of 128.4%, while attending urologists had an MPE of 207.8%. The most inaccurately estimated cost was for an endoscopic y-adapter, while the most accurate estimations were for a 1.5Fr nitinol ureteroscopic stone basket.

  CONCLUSIONS:

  Neither attending nor resident urologists are able to accurately estimate the cost of commonly used disposable devices. Improving urologists' understanding of device costs is necessary for improved cost control and a reduction in healthcare expenditures.