TAIPEI, TAIWAN ( - Introduction and Objectives: Financial waste of medical supplies is partly driven by overutilization of surgical items that can be replaced with more cost effective alternatives. This study sought to test a protocol providing surgeons with cost feedback relative to their surgeries. We hypothesized that providing feedback about costs would reduce marginal costs within the operating room (OR).

wceMethods: The protocol was developed for robotic partial nephrectomy. Costs pertaining to the 20 most recent cases were analyzed to establish a baseline. Through utilization analysis and discussion with surgeons, ten items were identified for replacement or omission. Real time feedback of total OR costs was provided to the surgeon after each case. The effects on marginal costs were analyzed on 18 cases after a five case washout period.

Results: Cost analysis of robotic partial nephrectomy indicates expenditures of $5,212.91 per case. The 10 modifiable items represent $1,188.75 (23%) in total cost. Post-washout period cost analysis found $860.01 (17%) in cost reduction from omission/replacement of modifiable items (p < 0.05). This process was repeated in Laparoscopic Donor Nephrectomy. Cost analysis indicates a $3599.91 per case baseline. The modifiable items represent $579.37 (16%) total costs with post-washout cost reduction of $420.98 (12%) (p < 0.05).

Conclusions: Providing surgeons with information and feedback related to OR costs may lead to a change in surgeons’ behavior and decreased overall costs.

Source of Funding: None

View an interview with Clinton D. Bahler, one of the authors of this study.


Presented by Clinton D. Bahler, Christian H. Tabib, Thomas J. Hardacker, Kevin M. Ball, and Chandru P. Sundaram at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan

Indiana University School of Medicine, Indianapolis, IN USA


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