Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs

Franklin Dexter, John T. Blake, Donald H. Penning, Brian Sloan, Patricia Chung, David Lubarsky

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Administrators at hospitals with a fixed annual budget may want to focus surgical services on priority areas to ensure its community receives the best health services possible. However, many hospitals lack the detailed managerial accounting data needed to ensure that such a change does not increase operating costs. The authors used a detailed hospital cost database to investigate by how much a change in allocations of operating room (OR) time among surgeons can increase perioperative variable costs. Methods: The authors obtained financial data for all patients who underwent outpatient or same-day admit surgery during a year. Linear programming was used to determine by how much changing the mix of surgeons can increase total variable costs while maintaining the same total hours of OR time for elective cases. Results: Changing OR allocations among surgeons without changing total OR hours allocated will likely increase perioperative variable costs by less than 34%. If, in addition, intensive care unit hours for elective surgical cases are not increased, hospital ward occupancy is capped, and implant use is tracked and capped, perioperative costs will likely increase by less than 10%. These four variables predict 97% of the variance in total variable costs. Conclusions: The authors showed that changing OR allocations among surgeons without changing total OR hours allocated can increase hospital perioperative variable costs by up to approximately one third. Thus, at hospitals with fixed or nearly fixed annual budgets, allocating OR time based on an OR-based statistic such as utilization can adversely affect the hospital financially. The OR manager can reduce the potential increase in costs by considering not just OR time, but also the resulting use of hospital beds and implants.

Original languageEnglish (US)
Pages (from-to)718-724
Number of pages7
JournalAnesthesiology
Volume96
Issue number3
DOIs
StatePublished - Mar 14 2002
Externally publishedYes

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Linear Programming
Operating Rooms
Costs and Cost Analysis
Budgets
Hospital Administrators
Hospital Costs
Ambulatory Surgical Procedures
Health Services
Intensive Care Units
Outpatients
Databases

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs. / Dexter, Franklin; Blake, John T.; Penning, Donald H.; Sloan, Brian; Chung, Patricia; Lubarsky, David.

In: Anesthesiology, Vol. 96, No. 3, 14.03.2002, p. 718-724.

Research output: Contribution to journalArticle

Dexter, Franklin ; Blake, John T. ; Penning, Donald H. ; Sloan, Brian ; Chung, Patricia ; Lubarsky, David. / Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs. In: Anesthesiology. 2002 ; Vol. 96, No. 3. pp. 718-724.
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