Supplementary Material for: Spotlighting turnover costs for pediatric ocular oncology exams under anesthesia

Introduction: While pediatric intraocular malignancies are rare, management requires frequent examinations under anesthesia (EUAs) which are financial costly. The purpose of the study was to measure operating room (OR) turnover costs and to estimate potential cost savings of reducing turnover time.

Methods: Turnover time data for EUAs with a single ocular oncology provider at the University of Michigan were analyzed from 2021-2023. Direct cost of OR turnover was set at $25.73 per minute, and turnover time after business hours utilized a cost multiplier for overtime costs. A sensitivity analysis for turnover reduction savings was based on reducing turnover times to a goal turnover time. Primary outcomes were total and average turnover time and costs for pediatric ocular oncology EUAs. Secondary outcomes included the potential cost savings associated with reduced turnover time goals.

Results: 158 EUAs with valid turnover times were included. Total turnover time and costs were 5034 minutes and $134,104. Average (standard deviation) turnover time and costs were 31.9 minutes (19.0) and $848.76 ($487.48). A majority of cases (65%) had turnover time less than 30 minutes, though a minority (23%) had a turnover time less than 20 minutes. By reducing maximum turnover time to 20 minutes, a total of $52,057 could be saved across these cases, or $329 per case.

Conclusions: Turnover time accounts for a notable proportion of OR costs, particularly for shorter cases. The average pediatric ocular oncology case had nearly $850 of turnover costs, much of which may be avoidable. Actions aimed at reducing turnover time are likely to have high return on investments if they are successful.