Allen Jeff W, Polk Hiram C
Department of Surgery, University of Louisville, Kentucky 40292, USA.
Am Surg. 2002 May;68(5):474-6.
Hospitals are pressured to cut expenses to generate a profit, but many current surgical procedures still fall below a "break-even" point. Laparoscopic cholecystectomy is a high-volume surgical procedure that can be profitable for hospitals if costs are reduced and complications minimized. Our limited liability corporation of independent surgical specialists examined the preference cards of ten surgeons who performed laparoscopic cholecystectomies in August 2000. We wished to determine whether these surgeons differed in their use of disposable equipment and devices for the same surgical procedure. All of the disposable equipment and devices studied were assigned a price by the hospital purchasing department that was representative of the hospital costs and not what was billed to the patient. The sum total of disposable instruments for a single operative case in which laparoscopic cholecystectomy was performed ranged from $92 to $637 (mean $333) depending on the preference of the surgeon. Our study points out the differences in expenses between surgeons. Maintaining this type of expense tracking can apply to other procedures and is a good place to start a surgeon-led and hospital-based cost-saving initiative.
医院面临着削减开支以实现盈利的压力，但目前许多外科手术仍未达到“收支平衡”点。腹腔镜胆囊切除术是一种高流量的外科手术，如果能降低成本并将并发症降至最低，对医院来说可能是盈利的。我们的独立外科专家有限责任公司检查了2000年8月进行腹腔镜胆囊切除术的10位外科医生的偏好卡。我们希望确定这些外科医生在同一项外科手术中使用一次性设备和器械的情况是否存在差异。医院采购部门为所有研究的一次性设备和器械设定了一个代表医院成本而非向患者收费的价格。根据外科医生的偏好，进行腹腔镜胆囊切除术的单个手术病例的一次性器械总价从92美元到637美元不等（平均333美元）。我们的研究指出了外科医生之间的费用差异。保持这种费用跟踪可以应用于其他手术，是启动由外科医生主导、以医院为基础的成本节约计划的一个良好开端。
