Sorber Rebecca, Dougherty Geoff, Stobierski Damian, Kang Christina, Hicks Caitlin W, Lum Ying Wei
Department of Surgery, The Johns Hopkins Hospital, Baltimore, Maryland.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
J Surg Res. 2020 Jul;251:281-286. doi: 10.1016/j.jss.2020.02.007. Epub 2020 Apr 30.
Increased health care spending concerns have generated interest in reducing operating room (OR) costs, but the cost awareness of the surgical team selecting intraoperative supplies remains unclear. This work characterizes knowledge of supply cost among surgeons and OR staff in a large academic hospital and seeks to examine the role of experience and training with regards to cost insight.
This work is a cross-sectional study of surgeons, trainees, nurses, and surgical technicians (n = 372) across all surgical specialties at a large academic hospital. Participants completed a survey reporting frequency of use and estimated cost for 11 common surgical supplies as well as opinions on access to cost information in the OR. Cost estimation error was expressed as the ratio of estimated-to-actual cost, and groups were compared with one-way analysis of variance and chi-squared testing. Spearman correlation (ρ) was used to describe the relationship between monotonic variables.
Overestimation error was universal and ranged widely (3.80-49.79). There was no significant difference in estimation accuracy when stratified by role or years of experience. Less expensive items had higher rates of estimation error than more expensive items (P < 0.001), and a moderately strong relationship was found between decreased item cost and increased estimation error (ρ: 0.49). The overwhelming majority (91%) of respondents expressed a desire to learn more about supply pricing.
Price knowledge of common supplies is globally impaired for entire surgical team but coexists with a strong desire to augment cost awareness. Improved access to cost information has a high potential to inform surgical decision-making and decrease OR waste.
对医疗保健支出增加的担忧引发了人们对降低手术室(OR)成本的兴趣,但选择术中用品的手术团队的成本意识仍不明确。这项研究描述了一家大型学术医院外科医生和手术室工作人员对用品成本的了解情况,并试图探讨经验和培训在成本洞察力方面的作用。
这项研究是对一家大型学术医院所有外科专业的外科医生、实习生、护士和手术技师(n = 372)进行的横断面研究。参与者完成了一项调查,报告了11种常见手术用品的使用频率和估计成本,以及对手术室成本信息获取的看法。成本估计误差表示为估计成本与实际成本的比率,通过单因素方差分析和卡方检验对各组进行比较。使用Spearman相关性(ρ)来描述单调变量之间的关系。
高估误差普遍存在且范围广泛(3.80 - 49.79)。按角色或经验年限分层时,估计准确性没有显著差异。较便宜的物品比较贵的物品有更高的估计误差率(P < 0.001),并且发现物品成本降低与估计误差增加之间存在中等强度的关系(ρ:0.49)。绝大多数(91%)的受访者表示希望更多地了解用品定价。
整个手术团队对常见用品的价格知识普遍欠缺,但同时又强烈希望增强成本意识。改善成本信息的获取有很大潜力为手术决策提供参考并减少手术室浪费。