Study: OR costs account for majority of hospital expenses

Procedures in the operating room (OR) represented a large portion of hospital costs in 2007, and are concentrated in few procedure types, according to an article in the December 2010 edition of Archives of Surgery.

Anne Elixhauser, PhD, and Roxanne M. Andrews, PhD, from the Agency for Healthcare Research and Quality (AHRQ) center for delivery, organization and markets, in Rockville, Md., analyzed data from the Healthcare Cost and Utilization Project 2007 Nationwide Inpatient Sample discharge data from a sample of U.S. short-term, acute-care, nonfederal hospitals.

Measuring the national volume of OR procedures overall and by type of procedure, resource use and costs, most frequent and expensive procedures, and trends, the researchers found that 15 million OR procedures were performed in 2007 (495 procedures per 10,000 population). Only 26.4 percent of hospitalizations involved an OR procedure; however, OR-related stays were responsible for 46.8 percent of hospital costs ($161 billion).

Patients aged 65 years and older were two to three times more likely to undergo OR procedures, according to the article.

“Compared with non-OR inpatients, OR patients were less severely ill (20.5 percent had the highest severity of illness vs. 24.6 percent for non-OR patients) and used more resources ($2,900 per day for OR patients versus $1,400 per day for non-OR patients),” the authors wrote.

The 15 most expensive procedures accounted for half of all procedure-related hospitalization costs and one-fourth of total hospital costs. Concluding their findings, the authors noted that volumes for four of the most expensive procedures increased between 1997 and 2007:
  • 20 percent for percutaneous transluminal coronary angioplasty;
  • 46 percent for cesarean delivery;
  • 46 percent for knee replacement; and
  • 45 percent for spinal fusion.

The volume of percutaneous transluminal coronary angioplasty declined 20 percent from 2006 to 2007, compared with a 56 percent increase in the prior decade.

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