A Study of Time-Dependent Operating Room Fees and How to save $100 000 by Using Time-Saving Products

Abstract

Problem/Issue: Product costs are a portion of the annually increasing costs of medical care. With diligent analysis of product costs, including the cost of time to use the product, the surgeon can reduce these spiraling costs. The purpose of this study was to provide the surgeon with the necessary information to make informed decisions about time- and cost-efficient products. Materials and Methods: This study involved phoning, faxing, or e-mailing hospitals and anesthesia groups across the United States to obtain time-dependent costs in the hospital operating room. Operating room fees charged by the hospital and anesthesiologist professional fees are included. Various products were then relatively compared with the time needed to prepare, use, or apply the product. Time and cost factors were then compared in order to ascertain the most time- and cost-effective products. Findings: The findings revealed an average of $62 per minute (rounded to the closest dollar) for the hospital operating room fee (range $21.80–$133.12) and $4 per minute for the anesthesiologist professional fee (range $2.20–$6.10), with a total of $66 per minute. This figure represents a marked increase from the 1991 rate of $20 per minute. Generalizations from this study indicate that time-cost efficiency is seen more so in kits (trays) than in nonkits and more so in disposables than in durables. Products that require fewer people are more time-cost efficient than those that require more people, and products that require fewer steps are more time-cost efficient than those that require more steps. Specific findings included time and cost dominance for the following products: staples over sutures, direct-current cautery over alternating-current cautery, syringes over Dermajet or Madajet, MagneSplint over suturing the nasal septum, aluminum-Velcro or aluminumfoam Denver Splint and Xomed Bridgemaster over any of the polypropylene heat-sensitive splints, Rhino Rocket and Merocel over Vaseline gauze, Brennan RhinoCath over manual blood removal, 1-piece Biplane liposuction cannulas over any 2-piece type, Doyle ear-dressing kit over component parts, Dale nasal dressing over component parts, preformed implants over manual forming, and Denver Splint kits over component parts. Conclusions: Each hospital or private suite will have different charges, and the range of product choices for each surgeon will be different. However, the principle is the same: If you save time, you will save money. In addition to the monetary benefit, the patient will be safer and receive less anesthesia, and the surgeon will have more time for his or her own social or professional life. Each surgeon should analyze the product choices and choose those products that will deliver quality care in less time. To save more than $100 000, the surgeon has to save only approximately 7 minutes per case on 250 cases.