PD28-03 COST-SAVINGS PROTOCOL IN THE ENDOUROLOGY SUITE DECREASES HEALTH CARE EXPENDITURES WITHOUT COMPROMISING QUALITY OF CARE

Abstract

You have accessJournal of UrologyStone Disease: Evaluation I1 Apr 2014PD28-03 COST-SAVINGS PROTOCOL IN THE ENDOUROLOGY SUITE DECREASES HEALTH CARE EXPENDITURES WITHOUT COMPROMISING QUALITY OF CARE Dilan Gupta, August Matteis, Fotima Askarova, Chad Ritch, and Mantu Gupta Dilan GuptaDilan Gupta More articles by this author , August MatteisAugust Matteis More articles by this author , Fotima AskarovaFotima Askarova More articles by this author , Chad RitchChad Ritch More articles by this author , and Mantu GuptaMantu Gupta More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2114AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cost-containment strategies are imperative to the financial well being of physician practices and hospital systems. Disposable equipment represents a significant portion of the cost of endourological procedures. We investigated if a cost-saving protocol could lead to decreased expense without compromising quality of care. METHODS We retrospectively analyzed actual disposable equipment costs of 4 categories of Endourology procedures performed by 3 surgeons: percutaneous nephrolithotomy (PCNL, N=30), ureteroscopy for renal stones (URSR, N=30), ureteroscopy for ureteral stones (URSU, N=30), and ureteroscopy with biopsy (URSB, N=20). We also reviewed operative times (ORT), estimated blood loss, (EBL) length of stay (LOS), need for stents, complications, need for ancillary procedures, and stone-free rates (SFR). We created cost sheets detailing actual costs of each piece of available disposable equipment available by category (guidewires, access devices, dilators, stents, etc.). Finally, we implemented a prospective cost-savings protocol wherein each surgeon would be apprised of the cost of each piece of equipment requested along with the costs of alternatives. Costs were analyzed as well as outcomes after implementation of the protocol. RESULTS The average cost per patient before and after the protocol were as follows: PCNL $1222 vs. $719 (p<.001), URSR $926 vs. $516 (p<.001), URSU $814 vs. $463 (p<.001), and URSB $880 vs. $417 (p<.001). There was no statistical difference in ORT, EBL, LOS, SFR, complications, or need for stents or ancillary procedures. Savings realized by category showed the biggest cost savings to be in type of laser fiber and dilation devices used, but savings were realized in every category. Extrapolated over one year, the total cost savings for our Endourology suite alone would be in excess of $300,000. CONCLUSIONS Implementation of a cost-savings protocol leads to substantial decrease in health care expenditures in the Endourology suite without compromising quality of care. Similar initiatives throughout the country have the potential to significantly impact health care costs. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e770 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Dilan Gupta More articles by this author August Matteis More articles by this author Fotima Askarova More articles by this author Chad Ritch More articles by this author Mantu Gupta More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...