Overlapping Surgery Increases Operating Room Efficiency Without Adversely Affecting Outcomes in Total Hip and Knee...

Area of Science:

• Orthopedic Surgery
• Health Economics

Background:

• Overlapping surgeries in total hip (THA) and knee (TKA) arthroplasty are increasingly common.
• Previous studies indicate no increase in complications with this practice.
• The cost-effectiveness of overlapping procedures remains under-explored.

Purpose of the Study:

• To evaluate the impact of overlapping surgery on procedural costs.
• To assess the effect of overlapping surgery on surgical productivity in THA and TKA.

Main Methods:

• Analysis of 4786 primary THA and TKA procedures from 2015-2018.
• Utilized time-driven activity-based costing to calculate procedural and personnel costs.
• Defined overlapping procedures as those with at least 30 minutes of overlap.

Main Results:

• 20.2% of procedures involved at least 30 minutes of overlap.
• Overlapping surgery increased operative time and personnel costs but significantly boosted the number of procedures per 8-hour block.
• Overlapping procedures yielded a $1215 higher profit margin per procedure with no adverse effect on 90-day readmission, length of stay, or discharge destination.

Conclusions:

• Overlapping noncritical portions of THA and TKA procedures is a safe practice.
• This strategy effectively enhances surgical productivity and profitability.
• The findings support overlapping surgery as a financially beneficial approach in joint arthroplasty.