|
|
October 16-20, 2010 San Diego, CA Home Abstract Archive Search Abstracts 2010 Session Grid 2010 Meeting Website Policy Statements ASA Website Feedback 
Visit Anesthesiology.org |
| Previous Abstract | Next Abstract |
| Printable Version |
|
A1262
October 25, 2005 2:00:00 PM - 4:00:00 PM Hall C4 |
| Increasing “Out of the or Cases”: Growth or Bankruptcy? |
|
Carlos U. Arancibia, M.D., Jagdip B. Shah, M.D., M.B.A., Jason G. Noble, M.D. Anesthesiology, Virginia Commonwealth University MCV Campus, Richmond, Virginia, United States |
|
Academic Anesthesiology department along with non profit the medical center are struggling financially due to many reasons. We decided to evaluate closely the growth of (OS – off site) patient done out of the OR and compare it with the growth of the total number of cases in our institution. Method. Using our database, we reviewed the number of cases and length of the procedures done in the main operating room suite, ambulatory surgery center and cases done out of the operating room. The actual time for each case is measured as patient in the OR to patient out of the OR and is archived in minutes. The average length per case in a given area is calculated dividing the total amount of time used by the number of cases in that area. The utilization of each area is calculated dividing total minutes of usage in 24 hours divided by total time staffed. In FY'00 we use to staff, one OS location. In FY'04 we allotted 1.5 OS daily due to increase demand. The fixed cost per hour of provider was calculated from institutional records and expressed in 2004 dollars. The fixed cost per hour calculated to be for anesthesiologists, CRNA & resident was $ 78.19, $ 76.20 & $ 16.91 respectively. The real staffing model used in the main OR one attending per to rooms and a mix of 50:50 resident/CRNA. In ambulatory surgery center the model had the same attending coverage but the mix was 33:66 resident/CRNA. In cases done out of the OR, there was 1:1 attending and a mix of 50:50 for resident/CRNA. The worked hours per year calculated 2447.5 for attending, 1920 for CRNA and 2880 for resident. In our institution the average collection per ASA unit is $20.5. We compared FY'00 with FY'04. Results.[figure1]Discussion.: Obviously the increase in patients at OS is a major additional cost for an academic anesthesiology department. It should be noticed that this calculations were done using actual usage of the time and do not include the necessary waste of time due to the multiple locations used out of the OR (Turnover time was excluded) In our situation, patient are done in 13 different (OS)locations. Averaging of hours, worked hours, fixed cost, reimbursement and staffing of various locations are likely to be underestimating across the board but simplicity is appealing to us Conclusion: The tremendous increase of anesthetic minutes OS location is a major factor in the dwindling financial situation of academic departments. Anesthesiology 2005; 103: A1262 |
Figure 1
 |