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Strum, DP MD; Vargas, LG PhD; May, JH PhD

doi: 10.1097/00000539-199802001-00048
Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Anesthesia/OR Economics

Department of Anesthesiology, University of Arkansas Medical Sciences, Little Rock, 72205 and the Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, 15213.

Abstract S48

INTRODUCTION: Contemporary medical institutions must manage surgical services efficiently to contain costs and ensure their own survival. Classical operating suite (OR) utilization is defined as the ratio of total OR time used to total OR time budgeted [1], that definition of utilization allows utilization inefficiencies to go undetected. To better detect inefficiencies, we measured underutilization and overutilization and estimated the potential savings if either or both could be minimized.

METHODS: We examined post hoc data from computerized records of all surgical cases performed over 6 years at a large teaching hospital. Weekends and holidays were eliminated from the analysis. To prepare utilization estimates, surgical records were categorized relative to budgeted OR time. Surgical cases beginning and ending during budgeted OR time were categorized as classic utilization, budgeted time not used for surgery was underutilization, and cases beginning before/after budgeted OR time were classified as overutilization. Cases which overlapped budgeted and non-budgeted OR time were split and the portions assigned appropriately. Costs were computed as $10/minute of operating suite time.

RESULTS: We analyzed data from 58,251 surgical cases, 5,122 different procedures, 18 operating suites and 9 surgical subspecialty blocks. Classic utilization by block ranged from 44% (cystoscopy) to 113% (neurosurgery). Average daily underutilization ranged 16% to 60% while overutilization ranged 4% to 49%. Average daily costs of underutilization and overutilization are illustrated for Tuesdays (Figure 1).

Figure 1

Figure 1

CONCLUSIONS: The surgical suites are one of the most costly functional areas in the hospital. Separating overutilization from underutilization of ORs allows one to detect opportunities for cost savings from improved OR scheduling and management that are hidden by traditional utilization measures. Our study shows that even at a conservative estimate of $10/minute per OR suite, the potential savings are significant. This study is important because we define an improved model for measuring OR utilization and apply it to subspecialty surgical block times, an important first step in capacity planning.

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1. Magerlain JM, Martin JB: Surgical demand scheduling: A review. Health Serv. Res. 1978:418-433.
© 1998 International Anesthesia Research Society