The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 448-451, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Cost containment via expense rationalization in open-heart surgery
LA Tomatis, RJ Schlosser, M Riahi, FS Stockinger and R Kanten
Hospital costs and the fees of the surgeon, assistant, anesthesiologist,
and cardiologist were reviewed in a community hospital doing 425 cardiac
operations in the year 1977. Each item of the bill was analyzed and
discussed with each department of the hospital. Changes made in the routine
saved approximately $1000 per patient--16% for patients having mitral
valves replacement (MVR), 15% for those having aortic valve replacement
(AVR), 21% for those having saphenous vein bypass grafts (SVBG), and 23%
for pediatric cases. The areas most likely to yield economic reductions
without alteration of the quality of care are operating room, patient room,
respiratory therapy, and pharmacy. Making the nurses, scrub technicians,
surgical assistants, residents, and staff surgeons aware of the cost of
each item and periodically discussing the alternatives could yield
surprisingly large savings.
