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Variability in Case Durations for Common Surgical Procedures.

Laurent G Glance1,2,3, Richard P Dutton4, Changyong Feng5

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This summary is machine-generated.

Surgical case duration varies widely across facilities for common procedures. This variation highlights opportunities to improve healthcare resource efficiency and patient outcomes.

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Healthcare Efficiency

Background:

  • Physician payments under the Merit-based Incentive Payment System (MIPS) are adjusted by a composite performance score.
  • Resource use is one of the four components of the MIPS performance score.
  • Facility-level variation in surgical case duration is explored as a potential performance metric.

Purpose of the Study:

  • To quantify facility-level variation in surgical case duration for common surgeries.
  • To examine the feasibility of using surgical case duration as a performance metric for resource use in healthcare.

Main Methods:

  • Analysis of 404,987 adult patient cases from the National Anesthesia Clinical Outcomes Registry.
  • Inclusion of six common general surgical and orthopedic procedures.
  • Application of mixed-effects multivariable time-to-event models (survival analysis) to assess surgical case duration.

Main Results:

  • Significant variation in surgical case duration was observed across facilities for the studied procedures.
  • High-performance facilities demonstrated substantially shorter surgical case durations compared to average and low-performance facilities.
  • For laparoscopic appendectomy, high-performance centers had a median duration of 69 minutes versus 92 minutes at low-performance centers.

Conclusions:

  • Wide variation in surgery case duration exists for common general and orthopedic surgeries.
  • This variability in care delivery presents an opportunity to enhance the efficient use of healthcare resources.
  • Surgical case duration may serve as a valuable performance metric for evaluating healthcare efficiency.