Qualitative and Economic Impact of Standardized and Digitalized Operation Room Processes in Obesity Surgery

Obes Surg. 2023 Dec;33(12):3860-3870. doi: 10.1007/s11695-023-06868-w. Epub 2023 Oct 23.

Abstract

Purpose: The introduction of innovative digital solutions in healthcare lags compared to other industries but promises high potential to create value in efficiency and quality. Increasing economic pressure forces hospitals to optimize operating room (OR) processes, in which such solutions might provide additional support.

Materials and methods: This retrospective case-control and monocentric study investigated if digitalized and standardized intraoperative surgical workflows of laparoscopic Roux-en-Y gastric bypass (LRYGB) have a significant impact on efficiency, quality, and economics. Logistic and linear regression models were used to apply propensity score matching (PSM) for efficiency and odds ratio for the quality analysis.

Results: The study included 49 patients per group. The results demonstrate a significant increase in efficiency and cost-effectiveness in the treatment group. Length of stay (LoS) was 1.2 days less than in the control group (5.6 vs. 4.4). The mean of total OR and skin-to-skin time increased by 3.7% (142.00 vs. 136.80) and 8.5%, respectively (93.88 vs. 85.94). The standard deviation (SD) of total OR and skin-to-skin time decreased by 7.36 min (26.86 vs. 34.22) and 8.98 min (23.20 vs. 32.18) in the treatment group. The results of the odds ratio did not provide any conclusions on quality. Overall, costs were reduced by 318 € per patient and total revenue improved by 10,073 €.

Conclusion: The implementation of digital workflow management systems in obesity surgery improves economic efficiency. Hospital management and payors should evaluate further support in research of the digitization of the OR, followed by reimbursement to increase and facilitate the accessibility to digital support systems.

Keywords: Costs; Digitization; Efficiency; Obesity surgery; Quality; Workflow management system.

MeSH terms

  • Bariatric Surgery*
  • Gastric Bypass* / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / surgery
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Treatment Outcome