Surgeon cost feedback through a surgical receipt program reduces cost in sinonasal surgery

Amarbir S. Gill, Renuka K. Reddy, Andrea G. Kulinich, Joanna Kim, Machelle D. Wilson, Jonathan Liang, E. Bradley Strong, Toby O. Steele

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Operating room (OR) costs are a large portion of healthcare expenses. This study evaluates the impact of a surgeon-targeted surgical receipt cost feedback system on OR supply costs in sinonasal surgery and individual components contributing to procedural cost. Methods: Itemized weekly surgical receipts detailing individual case supply costs were analyzed before and after the implementation of a non-incentivized surgeon cost feedback system between January 2017 and June 2019. Supply cost data collected 15 months prior to intervention was compared to cost data 15 months after implementation of the weekly automated receipt dissemination to surgeons. Chi square test was used for categorical data and the Wilcoxon test was used to compare change in cost. Univariate and mediation analyses were performed to assess variables impacting cost. Results: Of 502 sinonasal procedures analyzed, 239 were before and 264 after cost feedback implementation. There were no significant differences in age/gender, or indication for surgery. The median OR supply cost decreased from $1229.64 to $1097.22 (p = 0.02) after receipt implementation. There were effects of procedure type (p = 0.02), circulating nurse specialization (p < 0.001), steroid eluting stent (p = 0.002), and sinus drill (p < 0.001) on cost. Mediation analysis confirmed full mediation by decreasing use of steroid-eluting stents. Conclusion: Surgeon cost feedback in the form of individualized OR surgical receipts is an effective model to reduce supply cost per case in sinonasal surgery.

Original languageEnglish (US)
Pages (from-to)1049-1056
Number of pages8
JournalInternational Forum of Allergy and Rhinology
Issue number9
StatePublished - Sep 1 2020


  • FESS
  • allergic rhinitis
  • chronic rhinosinusitis
  • endoscopy
  • evidence-based medicine
  • health care economics
  • statistics

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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