Time-Driven Activity-Based Costing Analysis Identifies Use of Consumables and Operating Room Time as Factors Associated With Increased Cost of Outpatient Primary Hip Arthroscopic Labral Repair

Editorial Commentary: Improved Operating Room Efficiency Is the Best Way to Control Orthopaedic Costs

Current procedural terminology codes and assigned relative value units associated with arthroscopic hip surgery lag behind other joints in accurately describing, and often undervaluing, what surgery entails. Hip arthroscopy is expensive, and, to address inequity, procedural cost drivers require review. Consumable implants and operating room (OR) time drive the costs associated with the procedure. Hospitals, healthcare payors, patients, and surgeons all benefit from increasing OR efficiency and reducing equipment cost. However, the patient loses if financial strategy supersedes care delivery, and it is wrong to cut necessary use of consumables to save money. Fewer anchors is not the answer (yet we should use reusable, nonimplantable supplies when feasible). The greater opportunity to lower costs is improved OR efficiency, requiring a team approach with buy-in from perioperative, anesthesia, surgical staff, and administrators. OR time is a consistent driver of cost across every type of orthopaedic surgery. Studies evaluating strategies for OR efficiency in hip arthroscopy will benefit the field. By leading this effort, surgeons could be best positioned to address inadequate relative value units.