Variation in Intraoperative and Postoperative Utilization for 3 Common General Surgery Procedures

Area of Science:

• General Surgery
• Health Services Research
• Surgical Outcomes

Background:

• Reducing surgical costs is critical for hospital financial health.
• Variability in resource utilization impacts overall healthcare expenditure.

Purpose of the Study:

• To analyze variations in intraoperative and postoperative utilization for common general surgery procedures.
• To identify surgeon- and location-specific drivers of utilization variability.

Main Methods:

• Retrospective analysis of 7762 operations (laparoscopic cholecystectomy, appendectomy, hernia repair) from electronic health records.
• Examined intraoperative disposable supply costs, procedure time, and postoperative length of stay (LOS).
• Utilized crossed hierarchical regression models to adjust for case mix and identify variation sources.

Main Results:

• Surgeons explained 8.9%–38.2% of variation in supply costs and 15.1%–54.6% in procedure time.
• Location explained 12.1%–26.3% of variation in supply costs.
• A positive correlation existed between higher supply costs and longer procedure times for hernia repair.

Conclusions:

• Surgeons are key drivers of variation in surgical supply costs and procedure duration.
• Surgeon-specific utilization profiles can be valuable tools for cost reduction strategies.
• Minimizing variation in surgical resource use is essential for improving healthcare efficiency.