347 SUPPLY COST SAVINGS FOR HIGH-VOLUME UROLOGIC PROCEDURES AT AN ACADEMIC MEDICAL CENTER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness I1 Apr 2010347 SUPPLY COST SAVINGS FOR HIGH-VOLUME UROLOGIC PROCEDURES AT AN ACADEMIC MEDICAL CENTER James Dupree, Arshia Wajid, and Norm Smith James DupreeJames Dupree More articles by this author , Arshia WajidArshia Wajid More articles by this author , and Norm SmithNorm Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.413AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Over the past 20 years, there have been many efforts to reign in health care costs. Efforts are intensifying today, often focusing on hospital and physician costs. There is potential for surgeons to play a significant role in helping reduce supply costs while maintaining high quality patient care. We believe that increasing surgeons' understanding of surgical supply cost may be one method to safely reduce costs. METHODS We retrospectively reviewed the volume and supply cost data for all urologic procedures performed at our 897-bed, tertiary care academic medical center from September 2008 through August 2009. We identified the five highest volume urologic procedures and the five surgeons with the highest volume and median supply and disposable instrument cost for each of these procedures. We created a cost model to predict the supply cost saving that would occur if the profiled surgeons operated at the median supply cost. RESULTS We analyzed 1,075 cases including 321 open radical prostatectomies (RRP), 264 holmium laser ureteroscopies (laser URS), 189 robotic-assisted laparoscopic prostatectomies (RALP), 178 cystoscopy/ureteroscopies (URS), and 123 transurethreal resections of prostates (TURP). Total yearly supply cost for these procedures was $1,162,068. Table 1 describes the costs and potential savings for each procedure. Potential supply cost savings ranged from $21/case and $5,541/year for laser ureteroscopy, to $128/case and $24,189/year for RALP. The total potential supply cost savings for these five procedures is $78,376/year, a saving of 6.7%. For RALP, RRP, and laser ureteroscopy, the highest volume surgeons had the lowest median supply costs (data not shown). Table 1. Description of supply costs and supply cost savings ($) Procedure Mean cost/ case Median cost/ case Cost savings/ case Cost savings/ year RRP 392 312 75 24,009 Laser URS 896 984 21 5,541 RALP 3,194 3196 128 24,189 URS 528 454 69 12,355 TURP 830 734 100 12,282 CONCLUSIONS Small reductions in supply costs can have a large impact on yearly cost savings. From a sample of the five highest volume procedures and five highest volume surgeons, we have shown that operating at a median supply cost could save $78,376 per year. This is an underestimate of department-wide potential cost savings as these cases represented only 32% of 3405 total cases performed by the department. As a retrospective study, we have the advantage of avoiding the Hawthorne effect, where the act of observing subjects alters their behaviors. The next step will be analyzing how supply costs change now that surgeons know this data. Chicago, IL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e138 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Dupree More articles by this author Arshia Wajid More articles by this author Norm Smith More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...