Know your cost: Using price transparency in the operating room to control costs

Abstract

<h3>Objectives:</h3> Surgeons have significant choices when selecting specific disposable operating room (OR) equipment and supplies, while most are unaware of the costs associated with these choices. We used a cost transparency tool to demonstrate an impact on discretionary OR spending for disposable supplies. <h3>Methods:</h3> Patients undergoing laparoscopic hysterectomy or debulking within a gynecologic oncology department were included in this prospective, single-institution study. The operating room staff as well as the surgeons were informed of the cost of disposable equipment including the lowest-cost alternatives for commonly used supplies. Intraoperative supply cost feedback for all included procedures were provided to all surgeons in the department via a custom dashboard and monthly email reports with itemized costs. The results for all surgeons were transparent to all other surgeons in the department and the lowest cost surgeons were highlighted monthly. The primary outcome was percentage change in the cost of disposable supplies in the intervention year (11/1/2018-10/31/2019) as compared to baseline (11/1/2017-10/31/2018). Major postoperative complications including return to OR, wound dehiscence and wound infection were also collected. <h3>Results:</h3> A total of 21 surgeons performed 539 laparoscopic hysterectomies and a total of 18 surgeons performed 119 debulkings between 11/1/2017-10/31/2019. For laparoscopic hysterectomy, there was an overall average cost increase of 4.6% between the baseline year and the intervention year. Five (28%) of 18 surgeons with surgeries in both years demonstrated average decreases in costs by more than 5%. For debulking, there was an overall average cost decrease of 12.9% from baseline to the intervention year. Eight (53%) of the 15 surgeons with surgeries in both years demonstrated decreased costs by more than 5%. Complication rates did not change significantly over the study period (p=0.83). <h3>Conclusions:</h3> Transparency in the cost of disposable OR equipment and supplies may result in significant decrease in OR spending without affecting major postoperative complications.