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[Reimbursement budgets and treatment demands require cost saving--a short operations day as a possible solution in
1Universitäts-Hals-Nasen-Ohrenklinik, Fakultät für Klinische Medizin Mannheim.
Background:
Implementation of case related budgeting (similar to diagnosis related groups) has forced hospitals into more cost efficient management particularly with respect to surgery. Efforts to increase efficiency are concentrated on the labor intensive organization of the surgical ward. Operations of short duration are a major focal point. An analysis of the organizational structure of our hospital showed that significant improvement in operating theater management and utilization can be achieved in order to improve efficiency. A new pilot project was tested for economic efficiency.
Methods:
On eleven specified surgery days (129 patients) only short operations with a duration of less than 20 min were allowed (tonsillectomy, adenectomy, etc.). On each day 15 operations were performed in one operating room with two anesthesiology teams and one surgery team. This type of "short-operation day" was compared with a "regular" surgery day with two operating rooms, two anesthesiology teams, and two surgery teams. Efficiency, complication rates, economic outcome, and patient satisfaction were assessed.
Results:
Due to reduction of staff and a more efficient organization, we were able to reduce the costs for staff and the operating theater maintenance from DM 378,20 to DM 243,90 for each operation. Additionally, only one operating room was required instead of two. Complication rates (postoperative bleeding) were lower than before and patient acceptance and satisfaction was remarkable.
Conclusions:
Economic efficiency of short operations could be increased by organizational restricturing. The quality of the operations and the patients' satisfaction did not decrease.