Abstract
Background: Over the past decade, many hospitals have adopted hybrid operating rooms (ORs). As resources are limited, these ORs have to prove themselves in adding value. Current estimations on standard OR costs show great variety, while cost analyses of hybrid ORs are lacking. Therefore, this study aims to identify the cost drivers of a conventional and hybrid OR and take a first step in evaluating the added value of the hybrid OR. Methods: A comprehensive bottom-up cost analysis was conducted in five Dutch hospitals taking into account: construction, inventory, personnel and overhead costs by means of interviews and hospital specific data. The costs per minute for both ORs were calculated using the utilization rates of the ORs. Cost drivers were identified by sensitivity analyses. Results: The costs per minute for the conventional OR and the hybrid OR were €9.45 (€8.60-€10.23) and €19.88 (€16.10- €23.07), respectively. Total personnel and total inventory costs had most impact on the conventional OR costs. For the hybrid OR the costs were mostly driven by utilization rate, total inventory and construction costs. The results were incorporated in an open access calculation model to enable adjustment of the input parameters to a specific hospital or country setting. Conclusion: This study estimated a cost of €9.45 (€8.60-€10.23) and €19.88 (€16.10-€23.07) for the conventional and hybrid OR, respectively. The main factors influencing the OR costs are: total inventory costs, total construction costs, utilization rate, and total personnel costs. Our analysis can be used as a basis for future research focusing on evaluating value for money of this promising innovative OR. Furthermore, our results can inform surgeons, and decision and policy-makers in hospitals on the adoption and optimal utilization of new (hybrid) ORs.
Highlights
Over the past decade, many academic and teaching hospitals have adopted a hybrid operating room (OR), and many others are considering it
For the conventional OR we found a total cost per minute of €9.45 (€8.60-€10.23), for which the personnel costs amounted to 58%
This study identified that the main factors influencing the OR costs are: total inventory costs, total construction costs, utilization rate, and total personnel costs
Summary
Many academic and teaching hospitals have adopted a hybrid operating room (OR), and many others are considering it. The hybrid OR claims to improve efficiency by means of reducing secondary procedures and improve surgical performance which results in improved clinical outcomes.[2,3,4,5] Hybrid ORs are currently mainly used for cardiovascular surgery,[2,3,4] but for neurosurgery[6] and surgical oncology[7] interest is increasing. The first observational studies in cardiovascular surgery verified this promising nature by showing a reduced length of stay and reduced operation time.[8,9] Adoption of such an OR is a large investment. Since surgical healthcare expenditures already account for a large part of the annual healthcare costs, these innovative ORs have to prove themselves in terms of value for money.[10,11,12]
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