Profile of Inpatient Operating Room Procedures in US Hospitals in 2007

Objective: To provide an overview of inpatient operating room (OR) procedures in the United States. Design, Setting, and Patients: Healthcare Cost and Utilization Project 2007 Nationwide Inpatient Sample discharge data from a sample of US short-term, acute-care, nonfederal hospitals. Main Outcome Measures: National volume of OR procedures overall and by type of procedure, resource use and costs, most frequent and expensive procedures, and trends. Results: Fifteen million OR procedures were performed in 2007 (495 procedures/10 000 population). Only 26.4% of hospitalizations involved an OR procedure; however, OR related stays were responsible for 46.8% of hospital costs ($161 billion). Patients aged 65 years and older were 2 to 3 times more likely to experience OR procedures (eg, 1327 procedures/10 000 persons among those aged 65-84 years vs 626 procedures/10 000 persons for those aged 45-64 years). Compared with non-OR inpatients, OR patients were less severely ill (20.5% had the highest severity of illness vs 24.6% for non-OR patients) and used more resources ($2900/day for OR patients vs $1400/day for non-OR patients). The 15 most expensive procedures accounted for half of all procedure-related hospitalization costs and one-fourth of total hospital costs. Volumes for 4 of the most expensive procedures increased between 1997 and 2007: 20% for percutaneous transluminal coronary angioplasty, 46% for cesarean delivery, 46% for knee replacement, and 45% for spinal fusion. The volume of percutaneous transluminal coronary angioplasty declined 20% from 2006 to 2007, compared with a 56% increase in the prior decade. Conclusions: Procedures in the OR represent a large portion of hospital costs, and these costs are concentrated in few procedure types.