2 These capitated models focus on cost control, shifting the burden of cost minimization away from insurers and onto clinicians and administrators. Whereas in traditional fee-for-service models, more services equate to more revenue, new models, such as bundled payments, will reimburse hospitals a set amount for the surgical episode. Hospitals charge insurers and patients at a markup, 1 expecting a reimbursement (revenue) that is greater than their actual costs to generate a profit. Understanding hospital costs is critical to value-based care. Furthermore, understanding the composition of costs will allow those interested in value improvement to identify high-yield targets. These statewide data provide a generalizable benchmark for the value of OR time. Over time, the proportion of expenses dedicated to indirect costs has increased, while the proportion attributable to salary and supplies has decreased.Ĭonclusions and Relevance The mean cost of OR time is $36 to $37 per minute, using financial data from California’s short-term general and specialty hospitals in FY2014. Teaching hospitals had slower growth in costs than nonteaching hospitals. From FY2005 to FY2014, expenses in the OR have increased faster than the consumer price index and medical consumer price index. Wages and benefits accounted for approximately two-thirds of direct expenses (inpatient, $14.00 of $20.40 ambulatory, $14.35 of $20.90), with nonbillable supplies accounting for less than 10% of total expenses (inpatient, $2.55 of $37.37 ambulatory, $3.33 of $35.39). Direct expenses accounted for 54.6% of total expenses ($20.40 of $37.37) in the inpatient setting and 59.1% of total expenses ($20.90 of $35.39) in the ambulatory setting. There were no differences in mean expenditures when stratifying by ownership or teaching status except that teaching hospitals had lower mean (SD) expenditures than nonteaching hospitals in the inpatient setting ($29.88 vs $38.29 P = .006). The mean (SD) cost for 1 minute of OR time across California hospitals was $37.45 ($16.04) in the inpatient setting and $36.14 ($19.53) in the ambulatory setting ( P = .65). Thirty facilities (9.9%) were teaching hospitals. Results In FY2014, a total of 175 of 302 facilities (57.9%) were not for profit, 78 (25.8%) were for profit, and 49 (16.2%) were government owned. The proportion of cost attributable to indirect and direct expenses was identified direct expenses were further divided into salary, benefits, supplies, and other direct expenses. Main Outcomes and Measures Mean cost of 1 minute of OR time, stratified by setting (inpatient vs ambulatory), teaching status, and hospital ownership. The analysis focused on 2 revenue centers: (1) surgery and recovery and (2) ambulatory surgery. Objectives To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect.ĭesign, Setting, and Participants This cross-sectional and longitudinal analysis examined annual financial disclosure documents from all comparable short-term general and specialty care hospitals in California from fiscal year (FY) 2005 to FY2014 (N = 3044 FY2014, n = 302).
![doctors in training step 2 2014 torrent doctors in training step 2 2014 torrent](https://amysindicic.com/wp-content/uploads/2019/08/foto4.png)
No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely.
![doctors in training step 2 2014 torrent doctors in training step 2 2014 torrent](https://i.pinimg.com/originals/65/e4/85/65e4858180df28adcf8d4a4311256d79.jpg)
Importance Increasing value requires improving quality or decreasing costs.
![doctors in training step 2 2014 torrent doctors in training step 2 2014 torrent](https://image.slidesharecdn.com/doctors-in-training-step-1-2015-guide-160901102842-170220141339/95/doctors-intrainingstep12015guide160901102842-1-638.jpg)