1. Contribution margin per hour of operating room to reallocate unutilized operating room time: a cost-effectiveness analysis
- Author
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Davide La Regina, Luca Gabutti, Francesco Mongelli, Stefano Cafarotti, Andreas Perren, Luciano Anselmi, and Andrea Saporito
- Subjects
Contribution margin ,Cost–benefit analysis ,Computer science ,General Medicine ,Cost-effectiveness analysis ,Variable cost ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Profitability index ,Operations management ,Elective Surgical Procedure ,Reimbursement ,Healthcare system - Abstract
Background and objectives Contribution margin per hour (CMH) has been proposed in healthcare systems to increase the profitability of operating suites. The aim of our study is to propose a simple and reproducible model to calculate CMH and to increase cost-effectiveness. Methods For the ten most commonly performed surgical procedures at our Institution, we prospectively collected their diagnosis-related group (DRG) reimbursement, variable costs and mean procedural time. We quantified the portion of total staffed operating room time to be reallocated with a minimal risk of overrun. Moreover, we calculated the total CMH with a random reallocation on a first come-first served basis. Finally, prioritizing procedures with higher CMH, we ran a simulation by calculating the total CMH. Results Over a two-months period, we identified 14.5 hours of unutilized operating room to reallocate. In the case of a random “first come–first serve” basis, the total earnings were 87,117 United States dollars (USD). Conversely, with a reallocation which prioritized procedures with a high CMH, it was possible to earn 140,444 USD (p Conclusion Surgical activity may be one of the most profitable activities for hospitals, but a cost-effective management requires a comprehension of its cost profile. Reallocation of unused operating room time according to CMH may represent a simple, reproducible and reliable tool for elective cases on a waiting list. In our experience, it helped improving the operating suite cost-effectiveness.
- Published
- 2023