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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXII | Pages 29 - 29
1 May 2012
Roche A Bennett S Fischer B Molloy A
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NHS governance demands that services provided are clinically effective and safe. In the current financial climate and threats over public sector spending cuts, services offered by health care providers should also be cost-effective and profitable. Surgical specialties are often perceived as expensive with high implant costs. The aim of this audit was to cost the profit margin for foot/ankle surgery and test the accuracy of coding data collected.

Materials and Methods

Theatre data between January-April 2010 was retrospectively reviewed. Equipment inventories, operation notes and radiographs were reviewed for implants used. Clinical coding data was analysed and coded separately by the surgeon for comparison. Theatre expenses were calculated and accuracy estimated. Tariff generated and patient expenses were calculated and a final profit margin revealed. Wilcoxon matched-pair testing compared hospital recorded and surgeon calculated data.

Results

95 cases were included (51 forefoot, 5 midfoot, 6 arthroscopy, 12 hindfoot, 21 other), 65 female and 30 male patients. Theatre inventories were correct in 11% of cases. Mean inventory costs recorded were £90 and following surgeon analysis, £319. Total actual inventory cost was £30,306.23 but £8548.58 was recorded (p<0.0001). OPCS codes were deemed correct in 43% and incorrect in 57% of cases. Operation profit margin, including theatre, ward and salary costs was recorded as £158,229 but corrected profit margin with d inventories and OPCS codes was £121,584 (p=0.001).