Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Am Surg. 2020 Oct;86(10):1407-1410. doi: 10.1177/0003134820964494. Epub 2020 Oct 25.
Surgeons are often unfamiliar with the costs of surgical instrumentation and supplies. We hypothesized that surgeon cost feedback would be associated with a reduction in cost. A multidisciplinary team evaluated surgical supply costs for laparoscopic appendectomies of 7 surgeons (surgeons A-G) at a single-center academic institution. In the intervention, each surgeon was debriefed with their average supply cost per case, their partner's average supply cost per case, the cost of each surgical instrument/supply, and the cost of alternatives. In addition, the laparoscopic appendectomy tray was standardized to remove extraneous instruments. Pre-intervention (March 2017-February 2018) and post-intervention (March 2018-October 2018) costs were compared. Pre-intervention, the surgeons' average supply cost per case ranged from $754-$1189; when ranked from most to least expensive, surgeon A > B > C > D > E > F > G. Post-intervention, the surgeons' average supply cost per case ranged from $676 to $846, and ranked from surgeon G > D > F > C > E > B > A. Overall, the average cost per case was lower in the post-intervention group ($854.35 vs. $731.11, < .001). This resulted in savings per case of $123.24 (14.4%), to a total annualized savings of $29 151.
外科医生通常不熟悉手术器械和耗材的成本。我们假设外科医生的成本反馈将与成本降低相关。一个多学科团队在一家单中心学术机构评估了 7 名外科医生（外科医生 A-G）的腹腔镜阑尾切除术的手术供应成本。在干预中，每位外科医生都收到了他们的平均每例供应成本、他们的合作伙伴的平均每例供应成本、每个手术器械/供应品的成本以及替代品的成本的报告。此外，还将腹腔镜阑尾切除器械托盘标准化，以去除多余的器械。比较了干预前（2017 年 3 月至 2018 年 2 月）和干预后（2018 年 3 月至 2018 年 10 月）的成本。干预前，外科医生的平均每例供应成本从 754 美元到 1189 美元不等；按从最昂贵到最便宜的顺序排列，外科医生 A > B > C > D > E > F > G。干预后，外科医生的平均每例供应成本从 676 美元到 846 美元不等，按从最昂贵到最便宜的顺序排列，外科医生 G > D > F > C > E > B > A。总体而言，干预后组的平均每例成本较低（854.35 美元比 731.11 美元，<.001）。这导致每例节省 123.24 美元（14.4%），总年化节省 29151 美元。
