A break-even analysis of major ear surgery

Objectives: To determine variables which affect cost and profit for major ear surgery and perform a break-even analysis.

Design: Retrospective financial analysis.

Setting: UK teaching hospital.

Participants: Patients who underwent major ear surgery under general anaesthesia performed by the senior author in main theatre over a 2-year period between dates of 07 September 2010 and 07 September 2012.

Main outcome measures: Income, cost and profit for each major ear patient spell. Variables that affect major ear surgery profitability.

Results: Seventy-six patients met inclusion criteria. Wide variation in earnings, with a median net loss of £-1345.50 was observed. Income was relatively uniform across all patient spells; however, theatre time of major ear surgery at a cost of £953.24 per hour varied between patients and was the main determinant of cost and profit for the patient spell. Bivariate linear regression of earnings on theatre time identified 94% of variation in earnings was due to variation in theatre time (r = -0.969; P < 0.0001) and derived a break-even time for major ear surgery of 110.6 min. Theatre time was dependent on complexity of procedure and number of OPCS4 procedures performed, with a significant increase in theatre time when three or more procedures were performed during major ear surgery (P = 0.015).

Conclusion: For major ear surgery to either break-even or return a profit, total theatre time should not exceed 110 min and 36 s.