Surgical Supply Cost Awareness Is Associated with Lower Costs: A Single Center Experience

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)

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Clinical Implications

Surgeon awareness of operating room costs can be an effective tool for cost containment.

Register Now!
2023 National Conference

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog