Sampling error can significantly affect measured hospital financial performance of surgeons and resulting operating room time allocations

Franklin Dexter, David Lubarsky, John T. Blake

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Hospitals with limited operating room (OR) hours, those with intensive care unit or ward beds that are always full, or those that have no incremental revenue for many patients need to choose which surgeons get the resources. Although such decisions are based on internal financial reports, whether the reports are statistically valid is not known. Random error may affect surgeons' measured financial performance and, thus, what cases the anesthesiologists get to do and which patients get to receive care. We tested whether one fiscal year of surgeon-specific financial data is sufficient for accurate financial accounting. We obtained accounting data for all outpatient or same-day-admit surgery cases during one fiscal year at an academic medical center. Linear programming was used to find the mix of surgeons' OR time allocations that would maximize the contribution margin or minimize variable costs. Confidence intervals were calculated on these end points by using Fieller's theorem and Monte-Carlo simulation. The 95% confidence intervals for increases in contribution margins or reductions in variable costs were 4.3% to 10.8% and 6.0% to 8.9%, respectively. As many as 22% of surgeons would have had OR time reduced because of sampling error. We recommend that physicians ask for and OR managers get confidence intervals of end points of financial analyses when making decisions based on them.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalAnesthesia and Analgesia
Volume95
Issue number1
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

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Selection Bias
Operating Rooms
Confidence Intervals
Linear Programming
Costs and Cost Analysis
Ambulatory Surgical Procedures
Intensive Care Units
Decision Making
Outpatients
Surgeons
Physicians

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Sampling error can significantly affect measured hospital financial performance of surgeons and resulting operating room time allocations. / Dexter, Franklin; Lubarsky, David; Blake, John T.

In: Anesthesia and Analgesia, Vol. 95, No. 1, 01.01.2002, p. 184-188.

Research output: Contribution to journalArticle

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