From the 2019 HVPAA National Conference
Dr. Joshua Tseng (Cedars-Sinai Medical Center), Dr. Harry Sax (Cedars-Sinai Medical Center), Dr. Daniel Margulies (Cedars-Sinai Medical Center), Dr. Rodrigo Alban (Cedars-Sinai Medical Center)
Surgeons are often unfamiliar with the direct costs of surgical instrumentation and supplies. We hypothesized that surgeon awareness of operating room costs would be associated with a decrease in surgical supply costs and improved resource utilization for laparoscopic appendectomies.
A multidisciplinary team evaluated surgical supply costs for laparoscopic appendectomies of seven Trauma and Acute Care Surgery surgeons (surgeons A-G) at a single-center academic institution. In the intervention, each surgeon was debriefed with their average supply cost per case, their partner’s average supply cost per case, the cost of each surgical instrument/supply, and the cost of alternative instruments/supplies. In addition, the laparoscopic appendectomy tray was standardized to remove extraneous instruments. Pre-intervention (March 2017 to February 2018) and post-intervention (March 2018 to October 2018) costs were compared. Post-intervention total surgical costs were annualized to calculate cost savings after the intervention.
207 laparoscopic appendectomies were in the pre-intervention phase, and 158 were in the post-intervention phase. Pre-intervention, the surgeons’ average supply cost per case ranged from $754-$1189; when ranked from most to least expensive, surgeon A > B > C > D > E > F > G. Post-intervention, the surgeons’ average supply cost per case ranged from $676 to $846; when ranked from most to least expensive, surgeon G > D > F > C > E > B > A. Overall, the average cost per case was lower in the post-intervention group ($854.35 vs $731.11, p<.001). This resulted in savings per case of $123.24 (14.4%), to a total annualized savings of $29,151.
By educating surgeons on the cost of surgical supplies, comparing each surgeons’ cost to their peers, and standardizing the contents of a surgical tray, our institution significantly decreased the average supply cost per laparoscopic appendectomy.
Surgeon awareness of operating room costs can be an effective tool for cost containment.