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

Uchechi Iweala; Danny Lee; Ryan Lee; Jeffrey H Weinreb; Joseph R O'Brien; Warren Yu

doi:10.1016/j.jor.2019.09.012

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

J Orthop. 2019 Sep 11;16(6):534-542. doi: 10.1016/j.jor.2019.09.012. eCollection 2019 Nov-Dec.

Authors

Uchechi Iweala¹, Danny Lee², Ryan Lee², Jeffrey H Weinreb², Joseph R O'Brien³, Warren Yu²

Affiliations

¹ George Washington University in Washington, DC, New York University's Hospital for Joint Diseases, USA.
² George Washington University in Washington, DC, USA.
³ Washington Spine and Scoliosis Institute at OrthoBethesda in Bethesda, MD, USA.

Abstract

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.

Keywords: Arthroplasty; Complications; Cost-analysis; Inpatient; Operative time; Orthopaedic; Outpatient; Time-cost.