L W Traverso1, K Hargrave. 1. Department of Surgery, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Abstract
BACKGROUND: In order to improve the value of laparoscopic cholecystectomy (LC), we completed a prospective micro-cost analysis at a large, multispecialty referral hospital. METHODS: After a line-item cost database had been established, the following cost data were retrieved over a 1-year period (May 1993 through May 1994): operating room (OR), radiology, pharmacy, anesthesia supplies, recovery room, and hospital room. OR cost data was further divided into costs for room-staff, room setup, radiology, plus disposable and nondisposable equipment. Sixty uncomplicated LC cases were collected (30 cases each for 2 surgeons to examine the surgeon variable). RESULTS: Sixty percent of the hospital costs occurred in the OR. Disposable laparoscopic equipment accounted for 17% of the total hospital costs and 28% of the OR costs. Staff charges in the OR (cost estimated by the hospital using minutes in the LC room) represented 24% and 41%, respectively, of the above costs to the hospital. CONCLUSIONS: The areas in which hospitals and surgeons can improve the surgical value package (ie, decrease costs while maintaining quality) are in disposable equipment and efficient minimization of in-the-room time.
BACKGROUND: In order to improve the value of laparoscopic cholecystectomy (LC), we completed a prospective micro-cost analysis at a large, multispecialty referral hospital. METHODS: After a line-item cost database had been established, the following cost data were retrieved over a 1-year period (May 1993 through May 1994): operating room (OR), radiology, pharmacy, anesthesia supplies, recovery room, and hospital room. OR cost data was further divided into costs for room-staff, room setup, radiology, plus disposable and nondisposable equipment. Sixty uncomplicated LC cases were collected (30 cases each for 2 surgeons to examine the surgeon variable). RESULTS: Sixty percent of the hospital costs occurred in the OR. Disposable laparoscopic equipment accounted for 17% of the total hospital costs and 28% of the OR costs. Staff charges in the OR (cost estimated by the hospital using minutes in the LC room) represented 24% and 41%, respectively, of the above costs to the hospital. CONCLUSIONS: The areas in which hospitals and surgeons can improve the surgical value package (ie, decrease costs while maintaining quality) are in disposable equipment and efficient minimization of in-the-room time.
Authors: Nigel T Barwood; Liora J Valinsky; Michael S T Hobbs; David R Fletcher; Matthew W Knuiman; Steve C Ridout Journal: Ann Surg Date: 2002-01 Impact factor: 12.969
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