title: Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency.
abstract: Determination of operating room (OR) block allocation and case scheduling is often not based on maximizing OR efficiency, but rather on tradition and surgeon convenience. As a result, anesthesiology groups often incur additional labor costs. When negotiating financial support, heads of anesthesiology departments are often challenged to justify the subsidy necessary to offset these additional labor costs. In this study, we describe a method for calculating a statistically sound estimate of the excess labor costs incurred by an anesthesiology group because of inefficient OR allocation and case scheduling. OR information system and anesthesia staffing data for 1 yr were obtained from two university hospitals. Optimal OR allocation for each surgical service was determined by maximizing the efficiency of use of the OR staff. Hourly costs were converted to dollar amounts by using the nationwide median compensation for academic and private-practice anesthesia providers. Differences between actual costs and the optimal OR allocation were determined. For Hospital A, estimated annual excess labor costs were $1.6 million (95% confidence interval, $1.5-$1.7 million) and $2.0 million ($1.89-$2.05 million) when academic and private-practice compensation, respectively, was calculated. For Hospital B, excess labor costs were $1.0 million ($1.08-$1.17 million) and $1.4 million ($1.32-1.43 million) for academic and private-practice compensation, respectively. This study demonstrates a methodology for an anesthesiology group to estimate its excess labor costs. The group can then use these estimates when negotiating for subsidies with its hospital, medical school, or multispecialty medical group.
  
  
  CONCLUSIONS
  We describe a new application for a previously reported statistical method to calculate operating room (OR) allocations to maximize OR efficiency. When optimal OR allocations and case scheduling are not implemented, the resulting increase in labor costs can be used in negotiations as a statistically sound estimate for the increased labor cost to the anesthesiology department.
authors.affiliation: *Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas; †Department of Anesthesia, University of Iowa, Iowa City, Iowa; ‡Department of Anesthesiology, Jefferson Medical College, Philadelphia, Pennsylvania; §Medical Data Applications, Ltd., Jenkintown, Pennsylvania; ∥Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, Florida; and ¶Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Amr E
authors.initials: AE
authors.lastname: Abouleish
authors.forename: Franklin
authors.initials: F
authors.lastname: Dexter
authors.forename: Richard H
authors.initials: RH
authors.lastname: Epstein
authors.forename: David A
authors.initials: DA
authors.lastname: Lubarsky
authors.forename: Charles W
authors.initials: CW
authors.lastname: Whitten
authors.forename: Donald S
authors.initials: DS
authors.lastname: Prough
mesh_terms: D000776:Anesthesiology / Q000191:economics*; D001071:Appointments and Schedules; D003365:Costs and Cost Analysis; D009873:Operating Rooms / Q000191:economics* / Q000458:organization & administration*; D040841:Resource Allocation; D014481:United States