Dedicated operating room for trauma: A costly recommendation

Background: A dedicated operating room (OR) for urgent trauma cases is suggested by the American College of Surgeons Committee on Trauma as a necessary component of a Level I or II trauma center. We describe a cost analysis of this recommendation. Methods: Two models for staffing urgent trauma cases were constructed. Urgent trauma cases were defined as those taken to the OR within 30 minutes of arrival. In one model the OR was available 24 hours a day with in-hospital personnel. The second model used an out-of-hospital call schedule, assuming a patient-ready OR in 30 minutes. Costs and revenue per urgent case were calculated. A break-even analysis shows the number of cases required for costs to equal revenue. Results: In the 24-hour model, the cost/urgent case is $14,288; in the call-schedule model $3,243. The number of cases to break even in the 24-hour model is 1210; in the call-schedule model 375. Conclusions: A call-schedule model is the least costly way to staff an OR for urgent trauma cases.