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Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs
Journal article   Peer reviewed

Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs

Franklin Dexter, John T Blake, Donald H Penning, Brian Sloan, Patricia Chung and David A Lubarsky
Anesthesiology, Vol.96(3), pp.718-724
03/2002
DOI: 10.1097/00000542-200203000-00031
PMID: 11873050

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Abstract

Administrators at hospitals with a fixed annual budget may want to focus surgical services on priority areas to ensure its community receives the best health services possible. However, many hospitals lack the detailed managerial accounting data needed to ensure that such a change does not increase operating costs. The authors used a detailed hospital cost database to investigate by how much a change in allocations of operating room (OR) time among surgeons can increase perioperative variable costs. The authors obtained financial data for all patients who underwent outpatient or same-day admit surgery during a year. Linear programming was used to determine by how much changing the mix of surgeons can increase total variable costs while maintaining the same total hours of OR time for elective cases. Changing OR allocations among surgeons without changing total OR hours allocated will likely increase perioperative variable costs by less than 34%. If, in addition, intensive care unit hours for elective surgical cases are not increased, hospital ward occupancy is capped, and implant use is tracked and capped, perioperative costs will likely increase by less than 10%. These four variables predict 97% of the variance in total variable costs. The authors showed that changing OR allocations among surgeons without changing total OR hours allocated can increase hospital perioperative variable costs by up to approximately one third. Thus, at hospitals with fixed or nearly fixed annual budgets, allocating OR time based on an OR-based statistic such as utilization can adversely affect the hospital financially. The OR manager can reduce the potential increase in costs by considering not just OR time, but also the resulting use of hospital beds and implants.
Operating Room Nursing - organization & administration Operating Rooms - economics Operating Rooms - organization & administration Planning Techniques Programming, Linear Operating Room Nursing - economics Algorithms Ambulatory Surgical Procedures - economics Costs and Cost Analysis Accounting Health Care Rationing Elective Surgical Procedures - economics

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