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.