Observational study of operating room times for knee and hip replacement surgery at nine U.S. community hospitals

被引：49

作者：

Dexter F. ^{[1
]}

Weih L.S. ^{[2
]}

Gustafson R.K. ^{[2
]}

Stegura L.F. ^{[3
]}

Oldenkamp M.J. ^{[3
]}

Wachtel R.E. ^{[4
]}

机构：

[1] Division of Management Consulting, Departments of Anesthesia and Health Management and Policy, University of Iowa, Iowa City

[2] Knowledge Services, VHA Upper Midwest, Irving, TX

[3] Performance Improvement, VHA Upper Midwest, Irving, TX

[4] Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, IA

来源：

Health Care Management Science | 2006年 / 9卷 / 4期

关键词：

Anesthesia department; hospital; Arthroplasty; replacement; hip; knee; Community hospital; Hip replacement; Knee replacement; Operating rooms; Surgery; Surgical procedures; operative;

D O I：

10.1007/s10729-006-9997-9

中图分类号：

学科分类号：

摘要：

Knee (N = 185) and hip (N = 140) replacement cases were studied at nine community hospitals in the midwestern United States to determine whether certain management interventions could decrease case durations and reduce labor costs. Substantive (10 min) reductions in operating room (OR) time per case were not associated with: 1) increases in OR staffing, such as the addition of a surgical assistant; 2) complete elimination of all delays; or 3) increases in anesthesiologists' presence in the ORs. Substantive (10 min) increases in OR time per case were not associated with: 1) reductions in anesthesiologists' presence in the ORs or 2) changes in case scheduling to run fewer ORs, with some cases starting later in the day. Even if these factors had been associated with differences in OR time per case, any changes resulting from management interventions would still not have reduced labor costs. At these hospitals, OR nursing and anesthesia labor costs were fixed costs, because the OR workload averaged only 5.6 hr of cases per day. © 2006 Springer Science + Business Media, LLC.

引用

页码：325 / 339

页数：14

共 37 条

[21]

Strum D.P., Sampson A.R., May J.H., Vargas L.G., Surgeon and type of anesthesia predict variability in surgical procedure times, Anesthesiology, 92, pp. 1454-1467, (2000)

[22]

Zhou J., Dexter F., Macario A., Lubarsky D.A., Relying solely on historical surgical times to estimate accurately future surgical times is unlikely to reduce the average length of time cases finish late, J Clin Anesth, 11, pp. 601-605, (1999)

[23]

Hanss R., Buttergereit B., Tonner P.H., Bein B., Schleppers A., Steinfath M., Scholz J., Bauer M., Overlapping induction of anesthesia: An analysis of benefits and costs, Anesthesiology, 103, pp. 391-400, (2005)

[24]

Williams B.A., Kentor M.L., Williams J.P., Figallo C.M., Sigl J.C., Anders J.W., Bear T.C., Tullock W.C., Bennett C.H., Harner C.D., Fu F.H., Process analysis in outpatient knee surgery - Effects of regional and general anesthesia on anesthesia-controlled time, Anesthesiology, 93, pp. 529-538, (2000)

[25]

Macario A., Horne M., Goodman S., Dexter F., Heinen R., Brown B., The effect of a perioperative clinical pathway for knee replacement surgery on hospital costs, Anesth Analg, 86, pp. 978-984, (1998)

[26]

Birkes D., Dodge Y., Alternative Methods of Regression, pp. 111-125, (1993)

[27]

Manning W.G., Mullahy J., Estimating log models: To transform or not to transform?, J Health Econ, 20, pp. 461-494, (2001)

[28]

Duan N., Smearing estimate: A nonparametric retransformation method, JASA, 78, pp. 605-610, (1983)

[29]

Demidenko E., Mixed Models: Theory and Applications, pp. 2-5, (2004)

[30]

Abouleish A.E., Prough D.S., Whitten C.W., Zornow M.H., Lockhart A., Conlay L.A., Abate J.J., Comparing clinical productivity of anesthesiology groups, Anesthesiology, 97, pp. 608-615, (2002)

← 1 2 3 4 →