Related Experiment Video
Updated: Apr 21, 2026
Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
A Time-Driven Activity-Based Costing Analysis of Minor Hand Procedure Room Utilization at a Single Military
Karolina A Serhan1, George C Balazs1,2, Nicholas H Lake1
1Bone & Joint Sports Medicine Institute, Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, VA.
Purpose:
Create a time-driven activity-based costing model to quantify the financial and time-savings impact of implementing a minor procedure room to perform four common hand surgeries that were previously performed with the same local-only technique in the operating room.
Methods:
This is a retrospective cohort study. Institutional Review Board approval was obtained. Cases were identified using the Military Health System Data Repository via common procedure technology codes for carpal tunnel releases (CTR), deQuervian releases (dQR), trigger finger releases (TFR), and ganglion excisions (DWG). Cases were collected from 01 Jan 2022 to 31 Oct 2024. Personnel-associated costs and time analysis were determined by creating a time-driven activity-based costing model specific to our single military institution.
Results:
Sixty-nine cases performed in the operating room (OR) met inclusion. Of these, 34 were CTR, costing $182.61 per case, 8 were dQR, costing $145.52 per case, 9 were TFR, costing $219.92 per case, and 18 were DWG, costing $262.37 per case. In comparison, 77 cases performed in minor procedure room (MPR) met inclusion. Of these, 45 were CTR, costing $46.09 per case, 12 were TFR, costing $50.06 per case, 5 were dQR, costing $46.38 per case, and 10 were DWG, costing $60.04 per case. The personnel related cost per case in the MPR environment was significantly less when compared to its OR counterpart. The mean total time spent in the hospital on procedure day for MPR cohort was 69.22 minutes (±18.1), versus 189.52 (±62.69) for OR cohort. The mean patient waiting time for MPR group was 38.17 minutes (±16.89) versus 115.57 (±44.15) for OR group.
Conclusions:
Transition of local anesthesia hand cases from the OR to MPR at our military institution resulted in a 73.2% reduction in personnel-associated costs, a 63.5% reduction in the overall time patients spend in the hospital on their procedure day, and a 42.9% reduction in personnel required to support a case.
Type Of Study/Level Of Evidence:
Economic and decision analyses III.
