True Cost of Operating Room Time: Implications for an Orthopaedic Trauma Service

Abstract

Objective: To derive an accurate estimate of the operating cost per minute for an orthopaedic trauma room. Study Design: Retrospective economic analysis. Setting: Level II Trauma Center. Intervention: Hospital cost-accounting system query. Main Outcome Measurements: Direct fixed costs, direct variable costs, and hospital overhead. Results: Operating room per minute costs include direct variable costs of $2.77, direct fixed costs of $2.47, and hospital overhead costs of $10.97. Total per minute costs amounted to $16.21. This does not include professional fees of anesthesiology or surgeons or the costs of soft goods or implants. Conclusions: This is the first published study to document the true per minute cost of an orthopaedic trauma operating room. Such information is valuable when defining the value of a dedicated operating room, negotiating employment contracts, defining call stipends, and brokering capital purchases for the orthopaedic trauma service. Level of Evidence: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The Lateral Femoral Cutaneous and Over the Hip (LOH) Block for the Surgical Management of Hip Fractures: A Safe and Effective Anesthetic Strategy

“…A recent study by Childers et al 24 found, in general, the mean cost of OR time to be $36–$37 per minute. A similar study by Moody et al 25 found total per minute costs to be $16.21 for an orthopaedic trauma operating room, specifically. By using the estimates discussed earlier, using the LOH block instead of general or spinal anesthesia for hip fracture repair could potentially decrease costs by $480–$1110 per procedure.…”

Advantages of a Dedicated Orthopaedic Trauma Operating Room for Diaphyseal Femur Fractures

“…Decreasing the need for a second anesthetic episode and second surgical case has significant patient safety and cost savings benefit. 8 There are decreased implant costs, supply costs, and payment of staff such as the anesthesiologist and operating surgeon. The average external fixator cost priced from several local vendors was $2500.…”

“…Cost per minute of OR time varies widely in the literature. Moody et al 8 demonstrated an average orthopaedic trauma OR cost of $16.21 per minute. Their analysis included hourly wages for staff; however, it did not account for the increased wages due to the COVID19 pandemic and current worker shortages nor did it include physician charges.…”

Extracorporeal measurement of femoral nail length in the treatment of trochanteric hip fractures: the “box” technique

“…[29] The "box" technique may decrease costs by reducing surgical time as well as avoiding the cost of an intramedullary guidewire (list price $246 with the vendor most commonly used in this study). A recent study has shown operating room costs to be around $16 per minute, [30] but costs have been described to range from $21.80 to $133 per minute in the United States. [31] Importantly, the fluoroscopic images used to assess appropriate nail length in the "box" technique were obtained preoperatively.…”