Transcript of IOE 481 HOSPITAL SYSTEMS COST ACCOUNTING OPERATING …
HOSPITAL CLIENT: Mr. Scott Lovelace
PROJECT COORDINATOR: Mr. John Gialanella
PROJECT DIRECTOR: Dr. Richard Coffey
Executive Summary
The University of Michigan Hospital operating rooms currently use
two fixed hourly/half hourly charge rates for two overall
categories of surgery. In addition, flat fees are used for
procedures being done in the endoscopy rooms. These charges evolved
over a long period of time, but within the past two years were
linked to reimbursements because of the evolution of payments based
on diagnosis related groups. Questions, therefore, remained
concerning the cost and related profit margins for individual
surgeries as well as for categories of surgery.
During the winter semester of 1989, a team of three industrial and
operations engineering students, including one who is already an
RN, developed a LOTUS spreadsheet. This spreadsheet uses cost
accounting principles to calculate a cost per procedure. This tool
was then used to calculate costs for six procedures previously
identified by Scott Lovelace and Leo Rutledge.
A breakdown of the costs and comparison with current charges yields
the following basic conclusions:
A. Large profit margins on long, complicated procedures
B. Slim profit margins for endoscopy procedures mostly due to a
large indirect overhead burden and potential incomplete
reimbursement realities.
An analysis of the accounting steps used and further explanation of
our findings is provided in the following report.
Julie Hemmen Kathleen Koester Eric Meyer, BSN, RN
April 1989
INTRODUCTION AND BACKGROUND
This report summarizes the creation of a cost analysis model for
the University of Michigan Hospital main operating rooms and
endoscopy rooms. Currently, the hospital is charging for surgical
procedures using a fixed room rate for the first hour of surgery
plus a rate for each additional half hour of surgery. Chargeable
items are also billed separately from the room rates. This
structure is based on covering total expenses and revenues. An
actual breakdown on how the expenses are used in the operating
rooms has not been analyzed.
Historically, hospitals have been fortunate to obtain 100%
reimbursement for their outpatient procedures. Presently, though,
this has not been the case, third party reimbursement groups have
been paying only a percentage of the total charges. This reduction
in reimbursements and an increase in competition among hospitals
has created the need for a cost analysis of the operating
rooms.
The main objective of this project was to provide Scott Lovelace
with a cost analysis model to assess the actual costs of performing
a particular surgical procedure. The model was to be easy to use
and yet as accurate
(j as possible. We have created two parallel models in the form of
a LOTUS spreadsheet One model represents the main operating rooms
while the other is used for the endoscopy rooms. We feel that the
overhead costs of the two vary greatly and should not be allocated
equally.
APPROACH AND METHODOLOGY
In developing the model to calculate the costs of all surgery cases
we followed the procedure outlined in the proposal.
1. Determine, with the client, what specific operating room direct
and indirect costs affect all surgery cases. To determine the
specific costs we initially met with Project Coordinator, John
Gialanella, and outlined all the possible operating room costs. We
then met with Project Client, Scott Lovelace, and Administrative
Associate, Leo Rutledge, to verify the determined costs and their
categorization.
2. Develop a summation equation for determining total cost per
procedure. In the initial meeting with John Gialanella the costs
determined to affect all surgery cases were put into a summation
equation. This equation was then edited and verified by Scott
Lovelace and Leo Rutledge. The finalized equation follows:
Total Operating Room Cost per Procedure =
Direct Expenses + Indirect Expenses
Direct Expenses:
Variable Labor
Variable Commodities
Overhead Labor
Overhead Commodities
Indirect Expenses:
Institutional Overhead
3. Classify determined costs into well defined variables which will
be used in the equation. Through contact with John Gialanella,
Scott Lovelace, and Leo Rutledge, we determined the costs that
would be included in each of the terms of the equation.
4. Quantify through investigation all these current costs. Through
contact with several departments we collected the necessary data to
quantify the costs affecting all cases. Several interviews were
held with the nursing staff to aid in determining variable labor
cost, variable commodities cost, and overhead commodities cost. Leo
Rutledge supplied the projected operating rooms budget for the 1988
- 1989 fiscal year, data regarding the labor overhead of the
operating rooms department, and the breakdown of surgery cases and
hours for the previous year. The Capital Programs department
supplied the list
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of all depreciable items present in the operating rooms and their
values. The Finance Department supplied data regarding the
institutional overhead allocated to the operating rooms from other
non-revenue centers of the hospital. The collected data was
analyzed and, in coordination with Scott Lovelace, John Gialanella,
and Leo Rutledge, a method of allocating each cost to the cases was
determined.
5. Apply this cost model to the chosen six surgery cases. After the
model was complete, it was applied to the six surgery cases chosen
by Scott Lovelace and Leo Rutledge, shown below:
Colonoscopy Gastroscopy Hysterectomy Liver Transplant Right Heart
Catheter Coronary Artery Bypass - Graft (CABG)
The necessary data specific to the six surgeries was obtained
through interviews with the nursing staff and patient charge
sheets
6. Provide the client with a computerized model to determine costs
for all future surgery cases. The model was then put on a Lotus
•spreadsheet. A separate spreadsheet was developed for the main
operating rooms and the endoscopy rooms. With the input of at most
seven values corresponding to a particular surgery, the spreadsheet
contains all the necessary information to calculate the cost of any
surgery. The spreadsheet also contains the yearly input data, which
when updated is automatically calculated into the surgery
cost
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ANALYSIS OF MODEL
The following is a detailed qualitative explanation of the terms in
the total cost per procedure equation. The derivations of the terms
and the methods of allocation are given. A quantitative explanation
is provided in Appendix I.
Variable Labor Cost
The variable labor cost is the cost of the nursing staff in the
operating room during the surgery plus the fixed cost of one person
from the nursing staff setting up the room. The 1987 - 88 average
nursing and technician salaries paid, their projected raises, and a
benefits percentage were used to calculate the projected 1988 - 89
nursing and tech hourly salary. For one year the nursing staff
productive hours of 1579 was used. A weighted average hourly salary
was calculated based on the amount of presently employed nurses and
technicians. The computed variable labor cost for the main OR
is
$45.73t+$11.43
$23.16t+ $3.86
where t represents the length of the case in hours.
Variable Commodities
The variable commodities cost is the cost of the non-chargeable
medical/surgical supplies and the bedding/linen/laundry used during
the case. The operating rooms projection of expenses for the fiscal
year 1988 - 89 was used as the basis in calculating the cost. The
1987 - 88 percentage of chargeable med/surg supplies to total
med/surg supplies, 53.4%, was used to calculate the patient
non-chargeable med/surg supplies. The chargeable supplies will be
input into the model directly from the patient charge sheets. A
percentage of the variable commodities was separated for allocation
to the endoscopy rooms based on the ratio of the supplies ordered
for the endoscopy rooms to the total med/surg supplies.
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For the main OR the cost was allocated to each surgery based on a
combination of per case and per hour. A fixed cost was allocated to
each first hour of surgery and a variable cost for each additional
half hour of surgery. The reason for this being that a fixed amount
of supplies are used for the opening and closing of the patient
regardless of length or type of surgery, and then additional
supplies are used as the length of the surgery increases. This
percentage of the remaining half hour cost to the first hour cost
of 18.75% was determined from the current hospital operating room
charges based on reimbursement. The computed variable commodities
cost for main OR surgeries is
$152.39 + $28.57(2t-2)
where t is the length of the case in hours. The value for t input
into the above equation must be greater than or equal to 1.
For the endoscopy cases the variable commodities cost was allocated
evenly to all cases based on the projected number of cases for the
1988 -
89 year. The length of the endoscopy cases were not long enough and
did not have enough variation to justify allocating the cost based
on time. The computed variable commodities cost for endoscopy cases
is $18.35.
Overhead Labor
The overhead labor cost is the cost associated with the operating
rooms department personnel. The calculations were based on the
January 31, 1989 Staffing Summary Report, the special salary
percentages obtained from Leo Rutledge, and a benefits percentage.
The overhead labor includes the Professional and Administrative
Staff, the Office Staff, AFSCME, and the Nursing Professional and
Administrative Staff. For all cases the salaries of the AFSCME
Fixture and Wall Cleaner and the Custodian II were not used the
calculations because these positions will soon be eliminated. For
cases in the main OR, the salaries of the remaining three AFSCME
employees were included. For cases in the endoscopy rooms, the
salaries of the Stockkeeper II and the Operating Room Aides were t
included in the àalculation because their work does not pertain to
the endoscopy rooms, but the salary of the Instrument/Ster.
Processor was included. The cost of the overhead labor was
calculated to be $98.65 for cases in the main OR and $62.36 for
cases in the endoscopy rooms.
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Overhead Commodities
The overhead commodities cost is the cost of the non-variable
supplies used by the operating rooms department plus the cost of
the depreciation of the general equipment used during the case. The
amount of general equipment depreciation includes only the
equipment used in all cases and all equipment costing under
$10,000. The projected 1988 - 89 total equipment depreciation for
the operating rooms was used as the basis for the depreciation
calculations. Specialty equipment costing more than $10,000 and
endoscopy equipment were separated from the general main OR
depreciation. The equipment included in the endoscopy rooms
depreciation is listed in Appendix Ill. All depreciation values
were calculated based on the four Master Equipment Lists pertaining
to the four operating rooms accounts, which were obtained from the
Capital Programs Department.
This overhead commodities cost is allocated evenly to all cases
performed in the main OR and in the endoscopy rooms based on the
projected number of cases for the 1988 - 89 year. The calculations
are based on the operating rooms projection of expenses of the
fiscal year 1988 - 89. The yearly maintenance costs of the
lithotrypter and the heart lung machine are subtracted out of the
total overhead commodities to be inserted later for the specific
procedure. There is also a component for the depreciation of
specialty equipment to be input for the particularcase (see
Appendix II for the specialty equipment list). The overhead
commodities cost of each main OR and endoscopy procedure, without
including specialty equipment, was determined to be $55.18 and
$21.29 respectively.
Institutional Overhead (f’— I
The Institutional Overhead report was obtained by Fred Kegarise in
the finance department. Only 75% of these numbers were used in our
model since this report includes Mott and Kellog hospitals along
with the main hospital. We obtained 75% by dividing the cases
performed in the main hospital by the total number of cases
performed in the University of Michigan Hospital, which these
numbers in the report represent.
Each item was allocated either by case or by time according to the
nature of the item. For example, billing was allocated by case
since the time of
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the procedure was independent of the time spent on billing for the
case. Employee benefits, however, were allocated according to time
since staffing is based on surgical hours and employee benefits is
directly related to staffing. An itemized listing can be found in
the Appendix
Besides allocating by time and case, some items were also
multiplied by the square footage ratio of main operating rooms to
endoscopy rooms. These items include housekeeping/building and
exchange cart supplies. A second intermediate step was also
performed for admitting and 0/P registration. These were allocated
over inpatient and outpatient cases.
Even though the institutional overhead is an indirect cost, there
still exists variance between cases due to time of case and if the
procedure was performed in the main OR or endoscopy rooms. This
breakdown and calculations can be found in the Appendix I.
FINDINGS / CONCLUSIONS
The findings for the use of the model on the six specific surgeries
are as follows:
1) The operating rooms appear to be making money in all areas of
the surgical spectrum, i.e., from endoscopies to liver transplants.
See Figure 1.
2) Profit margins are large with the longer, more complicated types
of surgery. However, profit margins are less for both the
gastroscopy and colonoscopy due to the reality of incomplete third
party reimbursement.
3) A huge percentage of the costs associated with the endoscopy
procedures is from the indirect institutional overhead. See Figure
2.
4) The special equipment component of the endoscopy procedures is
very small at $2.54 per case. At the same time a patient flow
bottleneck seems to develop on occassion with colonoscopies related
to equipment breakdown. For example, only 4 colonoscopes were
functional on 4/7/89. The quantity of functional gastroscopes was
felt adequate at 8.
7
R%%
. F,,
- 1.0%
10.2%
p
‘——F,——
Procedure
RECOMMENDATIONS
1. Purchase 3-4 additional colonoscopes a Cost component small over
10 years and 3000
cases/yr b. Would alleviate patient flow bottleneck c. Should
increase lifetime of existing scopes
2. Raise flat fees for endoscopy procedures? a. Must remain
competitive b. These procedures generate revenue from
subsequent
therapeutic/surgical procedures
3. Move endoscopy rooms to an off site? a. Would decrease
institutional overhead? b. Would avoid parking structure/complex
building layout c. Would still need to retain one room to service
inpatients
4. Use our cost based model a. Spreadsheet quick and easy to use b.
Will maintain cost accounting basis for future monitoring
1. Can follow trend as surgical time increases/decreases 2. Can
follow trends for procedures involving specialty
equipment3 Can follow trend as pharmacy or materials management
move a satellite into OR
5. Enhance model in future a. Price initial non-chargeable supplies
from preference cards b. Make use of counts of lap sponges,
sutures, gloves, etc. for
cost accounting purposes c. Include scope maintenance costs in
endoscopy specialty
equipment (currently not included)
Nursing (1 .05)($30,000)/1\productive hours = $19.95 per hour
Technician (1 .0l)($23,600 roductive hours = $15.10 per hour
Weighted Average Salary 1’
Main OR [.75($1 9.95) + .25($1 5.10)] = $18.74 per hour Endoscopy
[.80($1 9.95) + .20($1 5.1 0)] = $18.98 per hour
Benefits Percentage = 22%
Surgery
Main OR 2 nurses for case Endoscopy I nurse for case
Set Up
Main OR 1 nurse for 1/2 hour Endoscopy 1 nurse for 1/6 hour
Final Equation
$45.73t + $11.43
$23.16t + $3.86
where t represents the length of the case in hours.
Variable Commodities /
Patient Non-Chargeables
Med/Surg Supplies $3,058,687 $2,963,265 $95,422
Bedding/Linen/Laundry $473, 147 $458,386 $14,761 Total
Non-Chargeables $3,531,834 $3,421,651 $110,183
Main OR
Average length of case = 2.77 hours Projected 1988 - 89 cases =
13,496 cases 2.77 hours/case X 13,496 cases = 37,384 hours 37,384
hours - 13,496 first hours = 23,888 remaining hours
= 47,776 remaining half hours $3,421,651 = 13,496x +
47,776(.1875x)
Variable Commodities Cost =
$152.39 + $28.57(2t-2)
where t is the length of the surgery in hours (t must be greater
than or equal to 1).
Endoscopy
V
P & A Office Nurs. P & A AFSCME Total Main OR $13.18 $20.76
$14.90 $49.81 $98.65/case Endoscopy $13.18 $20.76 $14.90 $13.52
$62.36/case
Overhead Commodities
$377,018
Projected 1988 -89 equipment depreciation $834,022 Less specialty
equipment depreciation -$350.31 3 General depreciation
$483,709
Main OR $483,709/i 3,496 cases = $35.84 Endoscopy $1 1,794*/6004
cases = $1.96
Total Overhead Commodities/case Main OR $19.33 + $35.84 = $55.18
Endoscopy $19.33 + $1.96 = $21.29
* see Appendix Ill for the items included in the Endoscopy
depreciation
Institutional Overhead Allocation
Description by case by hour
Employee benefits HIS Purchasing Admitting Billing General Admin.
$45.45 Hous/BIg. (main) $58.02 Hous/BIg. (endo) $47.37 Lin. &
Laundry Cafeteria $1.38 Nurs. Admin. $12.23 Surg. Supplies Serv.
Unit Mgmt. 0/P Registration Ex. Cart Sup. (main) $18.70 Ex. Cart
Sup. (endo) $15.27 Medical Records Nursing School $ 3.16
Inpatient case percentage = 58% Outpatient case percentage =
42%
$4.95
$9.06
fi I’s
- ‘-
:
Equipment
Cardiac Bypass Surgery Bypass Unit \ Circulatory Assist iø Heart
Lung Machine 1
Intraaortic Balloon 4
Gynecology Laser Surgical )
Orthopedics Bone Cutter ‘.
3 Tektronix Physio Monitors (EKG’s) 3 Olympus Lecturescopes
q7c-
3 Oxi Meters -øo Io
6 Cambridge Stretchers i’e. 57/ 3 Airshields BP Monitors
‘W7.7,
3 Valleylab Electrosurgery Units y 1605%
3 Craftsman Supply Carts —,
1 Acmi Heater Probe Unit 0
(‘S..
NAME OF CASE COLONOSCOPY
input Data For Each Particular Case
Length of case (hours) 0.50 Chargeable supplies (Cost) Specialty
instruments Pharmacy / other Specialty equipment dep./maint. 2.54
Inpatient service (0 or 1) 0.00 UMH charge 509.00
I I I I
I
I I I
vg. nursing labor cost per hour 19.95 (avg. technician labor cost
per hour 15.10 Senefits percentage 0.22
I I
Overhead Commodities I I I I
Total endoscopy depreciation per year 11794.00 Total general
overhead commodities : 377018.00 Total cases (main + endo) per year
19500 Total endoscopy cases per year 6004
Overhead Labor
I I
Indirect Expenses
I I I
Inst. overhead allocated by case 51.13 Inst. overhead allocated by
hour 1 138.87 dmitting cost by case 8.69 0/P registration cost by
case 090 I
U.
• I -
18 ‘..-._, I
I I ‘I cn I I I
I I I I I I 1 1
: 98.65 I I ,_ — — I
I I I I I I
I I I I
I I I I
—— I_ —
296.59
Total Variable Labor Costs
Total Variable Commodities
Total Overhead Commodities
Totaf Overhead Labor
Total Direct Expenses
I ‘IjI 1*1 * I I
INPUT DATA FOR ENDOSCOPY ROOMS
NAME OF CASE GASTRDSCOPY
Input Data For Each Particular Case
Length of case (hours) 0.50 Chargeable supplies (Cost) Specialty
instruments Pharmacy / other specialty equipment dep/maint. 3.47
Inpatient service (0 or 1) ooo UMH charge 363.00
a I I I
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a I
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a 60fl4 • a a • I I a I I I I
• a I I
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I I a a
Variable Labor Costs
Avg. nursing labor cost per hour Avg. technician labor cost per
hour Benefits percentage
Variable med/surg supplies
Total endoscopy depreciation per year Total general overhead
commodities Total cases (main + endo) per year Total endoscopy
cases per year
Overhead Labor
Indirect Expenses
Inst. overhead allocated by case 51.13 Inst. overhead allocated by
hour 138.87 Admitting cost by case 8.69 0/P registration cost by
case 0.90
Direct Expenses
a a a • I I
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‘:. cc : I I — — — a I I — — — I
I I I I I I • - ,_$ i
121.47 — —— — I —— I I
A II f,_I_J_ I I -,
0.50 1 a Ii 1I I I I• I.L•—t•• I I I
• —. I I a I I — I I
34.291. I I I I
Variable Labor Costs Surgical Time Setup Cost
Total Variable Labor Costs
Total Variable Commodities
Total Overhead Commodities
Total Overhead Labor
• a I I
a - 117 a • I I
19.33 1 I a I • I —— I
• I ‘I,l 77 Ia a .1-.!I a I I I • a I
• 9B • I .DJ I I
I I I
E_ Total Institutional Overhead
Total Indirect Expenses
Total Cost Per Procedure 1 297.52 1 a I- I a
UtIH charge I I : 363.00 1 I I * II I I I
Expected Profit Margin 1 65.48
/
NAME OF CASE Hysterectomy
Length o-f case (hours 1) Chargeable supplies (Cost) Specialty
instruments
. Pharmacy / other Specialty equipment dep./maint. Inpatient
service (0 or 1) UMH charge
Input Data For Each Year
Variable Labor Costs
Avg nursing labor cost per hour Avg. technician labor cost per hour
Sene-f its percentage
Variable med/surg supplies
Overhead Commodities
Total main OR depreciation per year Total general overhead
commodities Total cases (main + endo) per year Total main OR cases
per year
Overhead Labor
Indirect Expenses
2467.00
a aa a • aa a I aa a I j9 r a I 7,J a
a 15.10 a Ia a a a I - a a aa a
a a a 9 Ia J.i.. a a 357Ia - a a aa a a a I I
a aa a
a a I I
a a a a I Ia a a aa I
Inst. overhead allocated by case 51..13 Inst. overhead allocated by
hour 15295 Admitting cost by case 8.69 0/P registration cost by
case 0.90 1
Direct Expenses
I 4C
I 4 Cr. I a ._J_ a
a iiI — I
a ‘7j7 17 I I I
I C’ -a a a I SaJ4 . I
78.46: O..00 0.00 :
748.10 I a a Ia — I — —— a I
748.10 a a aa a a
1 1549.93 a i -I I a I I I
• a 467CO • a I .s..
• a a a a a
a ‘ 917.07 aa a
a a
Non—chargeable Supplies Chargeable Supplies Specialty Instruments
Pharmacy / other
Total Variable Commodities : 430.84 I I I a I a I I
I I a a
General Equipment Depreciation 35.84 * Specialty Equipment
Depreciation 1 0.00 1
General Overhead Commodities 1 19.33 1 • I p a• I I I
Total Overhead Commodities : 1 55.18
I LC I Ia ica.c,.J a a a • — — a I a a
801.83 a a I I a a
I I a a a a
I a a a a a
a
Total Institutional Overhead
UMH charge
Input Data For Each Particular Case
Length of case (hours >= 1) Chargeable supplies (Cost) Specialty
instruments Pharmacy / other Specialty equipment dep. /iriai nt
-
Inpatient service (0 or 1) UMH charge
1 1 50 -
123.24 1 - 00
I
Variable Labor Casts
Avg. technician labor cost per hour 8enef its percentage
Variable rned/sLtrg supplies I
Initial hour charge 152.39 1 Additional half hour charge
28.57
V
a a — I I
Total main OR depreciation per year 483709.00 Total general
overhead commodities 377018.00 1 Total cases (main ÷ endo) per year
19500 1 Total main OR cases per year 13496
Overhead Labor V
Total overhead labor cost per case 98.65
Inst overhead allocated by case 51.13 Inst. overhead allocated by
hour 15295 Admitting cost by case : 8.69 0/P registration cost by
case 0.90 1
Direct Expenses
I ‘ 411.01 ‘
Li... —I1 I —I— f’ 4. I /11= 7) a av C(r 1 di..) L d LI OF OS . S -
..J * .‘ 4.. -
Surgical Time 1150 Setup Cost 11.43
Total Variable Labor Costs 1 537.20 1 , I
Non—chargeable Supplies 1 752.36 Chargeable Supplies 1 2025.64
Specialty Instruments I o.:o : Pharmacy / other 0.00 1
Total Variable Commodities 2776.00
C) General Equipment Depreciation 35.84 Specialty Equipment
Depreciation 1224
* General Overhead Commodities I 19.33 a a a aa a a a
Total Overhead Commodities 178.42 1 I I I I I I I I
Total Overhead Labor I 98.65 .1 I I a I I I I a
Total Direct Expenses 1 3592.27
I I
Indirect Expenses
I I I I I a S I
I I 9 4 a, a a .1. .1. .1...) * I
I a — I I I I I I
: 1918.75 1 I a I I I I I
Total Indirect Expenses
INPUT DATA FOR MAIN OR
NAME OF CASE CABO
LenQth of case (hours >= Chargeable supplies (Cost> Specialty
instruments Pharmacy / other Specialty equipment dep./maint.
Inpatient service (C) or 1) UMH charge
Input Data For Each Year
Variable Labor Costs
6 . f)0 214731
123.24 1 — 00
I I
I I
Avg. nursing labor cost per hour 19.95 Avg. technician labor cost
per hour 15.10 Benef its percentage 0.22
Variable med/surg supplies
Initial hour charge 1 152.39 Additional half hour charge
28.57
I I I - I
Overhead Commodities
Total main OR depreciation per year 483709.00 Total general
overhead commodities 1 377018.00 Total cases (main + endo) per year
1 19500 Total main OR cases per year 13496
Overhead Labor
Indirect Expenses
98 ‘.o_
Inst. overhead allocated by case I 51.13 I Inst. overhead allocated
by hour 1 152.95 I Admitting cost by case 8.69 1 0/P registration
cost by case 0.90 1
TOTAL OPERATING ROOM COST IN MAIN PER PROCEDURE
Direct Expenses
Variable Labor Casts 45.72 Surgical Time : .oo Setup Cost I 11.43
1
I I I I I I I I
Total Variable Labor Costs I 285.75 1
Non—chargeable Supplies 438.09 1 Chargeable Supplies I 2147.31
Specialty Instruments I 0.00 Pharmacy / other 0.00 1 I
Total Variable Commodities 1 2585.40
I I I I I I I I
General Equipment Depreciation 35.84 Specialty Equipment
Depreciation 123.24 1 General Overhead Commodities I 19.33
I I I Ia — a a
Total Overhead Commodities 178.42 I I I I I I $ I
1 98.65:Total Overhead Labor
I I I i I€ ‘)i Ia a ._j.-rc I
I I I I I I I I
I I I Ia i I I
I I I I I I a I
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a a I I I I I I I I cr-yr Ia I I I
I I a Ia I I — —— I
Total Indirect Expenses
Total Cast Per Procedure 4125.73 1 a a I I I
UMH charge I
(
NAME OF CASE Right Heart Caheter
Input Data For Each Particular Case
Length of case (hours >= 1) 1.00 Chargeable supplies (Cost)
158.00 1 Specialty instruments Pharmacy / other Specialty equipment
dep./maint. Inpatient service (0 or 1) 1.00 UMH charge
1002.00
Input Data For Each Year
Variable Labor Costs
AVg. nursing labor cost per hour 19.95 Avg. technician labor cost
per hour 15.10 Eenefits percentage 0. 22
I I I I
V I I
I I I
Total main OR depreciation per year 4837t:9.oo Total general
overhead commodities : 377018.00 Total cases (main + endo) per year
19500 Total main OR cases per year : 13496
Overhead Labor
Total overhead labor cost per case 98.65 a Ia a
Inst. overhead allocated by case Inst. overhead allocated by hour
Admitting cost by case 0/P registration cost by case
51. 13 152.95
Direct Expenses
i.oo : • ii 11’ I I
L.L-_. I I
I I
310.39 I I
I I I I I — I — —— 1
: 55.18 I I I I I - I I I
: 98.65 I I I I I I I I
521.36 I I I I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I •j) I I I £.L_l, I
• I I I I — I — I I
I I I ijb 77 I I I I -..L.L..!I
I I I I I I I I
73413
(....
(•
Total Variable Labor Costs
Total Variable Commodities
Total Overhead Commodities
Total Overhead Labor
Total Direct Expenses