The cost of elective orthopedic surgery on Syrian refugees: A single-center experience

BackgroundWith a continued rise in healthcare expenditures, there is a demonstrable focus on curbing expenses. Mechanical thrombectomy (MT) is the standard of treatment for large vessel occlusions (LVOs); however, considerable costs are associated with devices utilized in each procedure. We report our institution’s experience with capitation pricing models negotiated with three different companies.MethodsWe retrospectively reviewed a prospectively maintained database from February 2018 to August 2019 identifying cases performed under capitation models. We calculated the cost of equipment for each thrombectomy using the cost for individual devices utilized (virtual) and compared this sum to the total derived from cost-negotiated bundled equipment packages. This was compared with real-world cases that did not meet capitation criteria during this study period.Results107 cases met the criteria for capitation; 39 cases used company A’s models (28 with stentrievers), 44 cases used company B’s models (3 with stentrievers), and 24 cases used company C’s models (14 with stentrievers). Overall, there was a net savings of $202 370.50 utilizing the capitated model ($689 435 vs $891 805.50), amounting to $1891.31 savings per case. Mean capitation was lower ($6972±2774) compared with virtual ($8794±4614) and real-world non-capitation costs ($7176±3672).ConclusionThe negotiated capitated pricing model yielded total cost savings associated with equipment from each company. Overall mean capitation costs were lower than virtual and real-world cases. This may serve as a model for other centers in controlling costs for patients undergoing MT for LVO.

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The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden

Patient Safety in Surgery ◽

10.1186/1754-9493-6-11 ◽

2012 ◽

Vol 6 (1) ◽

pp. 11 ◽

Cited By ~ 24

Author(s):

Annette Erichsen Andersson ◽

Ingrid Bergh ◽

Jón Karlsson ◽

Bengt I Eriksson ◽

Kerstin Nilsson

Keyword(s):

Orthopedic Surgery ◽

Surgical Site Infections ◽

Evidence Based ◽

Single Center ◽

Single Center Experience

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Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience

The American Surgeon ◽

10.1177/0003134820964494 ◽

2020 ◽

Vol 86 (10) ◽

pp. 1407-1410

Author(s):

Joshua Tseng ◽

Harry C. Sax ◽

Bruce L. Gewertz ◽

Daniel R. Margulies ◽

Rodrigo F. Alban

Keyword(s):

Laparoscopic Appendectomy ◽

Intervention Group ◽

Surgical Instrument ◽

Single Center ◽

Post Intervention ◽

Single Center Experience ◽

Supply Costs ◽

The Cost ◽

Cost Awareness ◽

Post Intervention Group

Surgeons are often unfamiliar with the costs of surgical instrumentation and supplies. We hypothesized that surgeon cost feedback would be associated with a reduction in cost. A multidisciplinary team evaluated surgical supply costs for laparoscopic appendectomies of 7 surgeons (surgeons A-G) at a single-center academic institution. In the intervention, each surgeon was debriefed with their average supply cost per case, their partner’s average supply cost per case, the cost of each surgical instrument/supply, and the cost of alternatives. In addition, the laparoscopic appendectomy tray was standardized to remove extraneous instruments. Pre-intervention (March 2017-February 2018) and post-intervention (March 2018-October 2018) costs were compared. Pre-intervention, the surgeons’ average supply cost per case ranged from $754-$1189; when ranked from most to least expensive, surgeon A > B > C > D > E > F > G. Post-intervention, the surgeons’ average supply cost per case ranged from $676 to $846, and ranked from surgeon G > D > F > C > E > B > A. Overall, the average cost per case was lower in the post-intervention group ($854.35 vs. $731.11, P < .001). This resulted in savings per case of $123.24 (14.4%), to a total annualized savings of $29 151.

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