Characterizing efficiency in the ambulatory surgery setting: An analysis of operating room time and cost savings in orthopaedic surgery.

Changing surgical settings for orthopaedic procedures could drive reductions in operative time and reduce healthcare costs. Time-cost differences were calculated using estimated operating room costs by utilizing the ACS-NSQIP database. Multivariate analyses were generated from propensity-matched cohorts to assess differences between inpatient/outpatient outcomes, and whether surgical length increased risk for complications. Outpatient procedures demonstrated time-cost savings of $1716.06. Generally, inpatient procedures demonstrated increased rates of major/minor complications, reoperation, extended LOS, and unplanned readmission (p < 0.001). Overall, longer operative times increased the risk for postoperative complications (p ≤ 0.001). More elective orthopaedic procedures done on an outpatient basis may result in substantial time-cost savings.