Operating Room Efficiency Before and After Entrance in a Benchmarking Program for Surgical
Operating room efficiency before and after entrance in a benchmarking program for surgical process data
Sara Pedron, Vera Winter*, Eva-Maria Oppel, Enno Bialas
Journal of Medical Systems
Online Resource2: Sensitivity Analysis Results Appendix
*corresponding author:
Vera Winter, MA, PhD
Department of Political Science and Public Management, University of Southern Denmark, Denmark.Campusvej 55, 5230 Odense (DK)
+45 6550 1884
Appendix B: Sensitivity Analysis with hospital specific fixed effects
Outcome / Overall / General H / Main H / Max H / Uni HLate starts
(min) / Year (1) / -0.814 / * / -0.379 / -1.655 / * / 0.925 / -1.518 / **
(0.32) / (0.38) / (0.697) / (0.85) / (0.546)
Year (2) / -1.273 / ** / 0.033 / -2.285 / ** / -0.212 / -2.130 / **
(0.397) / (0.442) / (0.859) / (1.12) / (0.676)
Intercept / 6.679 / ** / 5.368 / ** / 2.012 / 1.789 / 10.542 / **
(1.261) / (1.725) / (1.891) / (2.18) / (2.515)
adj. R2 / 0.468 / 0.597 / 0.411 / 0.349 / 0.497
N / 7252 / 2268 / 2052 / 1240 / 1692
N / 64 / 25 / 17 / 12 / 10
Turnover time (min) / Year (1) / 0.758 / ** / 0.402 / 1.036 / 1.620 / ** / 0.216
(0.265) / (0.367) / (0.569) / (0.48) / (0.68)
Year (2) / 1.828 / ** / 1.369 / ** / 2.033 / * / 3.542 / ** / 0.649
(0.402) / (0.483) / (0.797) / (0.836) / (1.091)
Intercept / 45.453 / ** / 35.618 / ** / 37.355 / ** / 51.574 / ** / 59.263 / **
(2.281) / (3.009) / (4.312) / (4.963) / (5.246)
adj. R2 / 0.629 / 0.593 / 0.530 / 0.504 / 0.363
N / 7272 / 2268 / 2052 / 1260 / 1692
N / 64 / 25 / 17 / 12 / 10
Rawutilization
(%) / Year (1) / -0.095 / 0.178 / -0.638 / -2.613 / 1.846 / *
(0.467) / (0.58) / (0.809) / (1.738) / (0.83)
Year (2) / 0.395 / 0.485 / 0.112 / -1.559 / 1.739
(0.644) / (0.951) / (0.981) / (2.464) / (1.135)
Intercept / 37.118 / ** / 30.100 / ** / 32.121 / ** / 41.035 / ** / 42.791 / **
(1.593) / (2.649) / (2.715) / (3.461) / (1.947)
adj. R2 / 0.387 / 0.476 / 0.431 / 0.281 / 0.344
n / 7186 / 2250 / 2024 / 1238 / 1674
N / 64 / 25 / 17 / 12 / 10
Note: ** p<.01; * p<.05.Additionalconfounders:average case duration (ACD), Months.
Hospital types: General H: general hospitals, Main H: main hospitals, Max H: maximum care hospitals, Uni H: universitymedical centers.
Outcome / Overall / General S / Trauma S / Ortho S / Uro S / Eear-Nose S
Late starts
(min) / Year (1) / -0.814 / * / -0.926 / -0.519 / -0.112 / -1.566 / -0.907
(0.32) / (0.512) / (0.641) / (0.856) / (1.005) / (0.811)
Year (2) / -1.273 / ** / -1.270 / 0.669 / -2.126 / * / -2.397 / * / -2.076 / *
(0.397) / (0.665) / (0.715) / (0.998) / (1.183) / (0.839)
Intercept / 6.679 / ** / 5.822 / ** / 8.432 / ** / 1.140 / 10.177 / ** / 4.733 / **
(1.261) / (0.865) / (1.518) / (2.251) / (1.487) / (1.497)
adj. R2 / 0.4679 / 0.6800 / 0.8368 / 0.7534 / 0.5819 / 0.7539
N / 7,252 / 2,268 / 1,548 / 1,188 / 1,312 / 936
N / 64 / 59 / 42 / 30 / 33 / 26
Turnover time
(min) / Year (1) / 0.758 / ** / 0.786 / 1.024 / 1.486 / ** / 0.194 / -0.359
(0.265) / (0.44) / (0.587) / (0.437) / (0.777) / (0.707)
Year (2) / 1.828 / ** / 2.123 / ** / 2.971 / ** / 2.079 / ** / 0.946 / 0.214
(0.402) / (0.682) / (0.8) / (0.729) / (1.433) / (0.851)
Intercept / 45.453 / ** / 51.467 / ** / 48.598 / ** / 49.943 / ** / 58.097 / ** / 42.931 / **
(2.281) / (2.026) / (2.768) / (1.574) / (2.901) / (1.304)
adj. R2 / 0.6292 / 0.8902 / 0.906 / 0.8984 / 0.728 / 0.926
n / 7,272 / 2,268 / 1,548 / 1,188 / 1,332 / 936
N / 64 / 59 / 42 / 30 / 33 / 26
Rawutilization
(min) / Year (1) / -0.095 / -0.386 / -0.311 / 0.783 / -0.432 / 0.253
(0.467) / (0.709) / (0.766) / (1.313) / (1.698) / (0.954)
Year (2) / 0.395 / 0.571 / -0.230 / 0.544 / 0.301 / 1.265
(0.644) / (0.99) / (0.974) / (1.424) / (2.579) / (1.29)
Intercept / 37.118 / ** / 45.225 / ** / 37.459 / ** / 33.647 / ** / 36.508 / ** / 27.596 / **
(1.593) / (1.954) / (4.347) / (1.853) / (3.256) / (3.381)
adj. R2 / 0.3868 / 0.6409 / 0.756 / 0.6807 / 0.4067 / 0.716
n / 7,186 / 2,245 / 1,527 / 1,178 / 1,308 / 928
N / 64 / 59 / 42 / 30 / 33 / 26
Note: ** p<.01; * p<.05.Additionalconfounders:average case duration (ACD), Months.
Specialties: General S: general surgery, Trauma S: trauma surgery, Uro S: urology, Ortho S: orthopedicsurgery, Ear-Nose S: ear-nose-throatsurgery.
Appendix C: Sensitivity analysis with unbalanced panel data
Late starts (min) / Turnover time (min) / Raw utilization (%)Late starts (min) / Turnover time (min) / Rawutilization (%)
Y(0) / Δ Y(1) - Y(0) / Δ Y(2) - Y(1) / Y(0) / Δ Y(1) - Y(0) / Δ Y(2) - Y(1) / Y(0) / Δ Y(1) - Y(0) / Δ Y(2) - Y(1)
Mean (SD) / Diff (SE) / Diff (SE) / Mean (SD) / Diff (SE) / Diff (SE) / Mean (SD) / Diff (SE) / Diff (SE)
Overall / 11.31 (±8.64) / -0.83 (0.25) / ** / -1.31 (0.25) / ** / 56.54 (±14.01) / 0.95 (0.41) / * / 2.14 (0.41) / ** / 47.03 (±12.91) / -0.13 (0.36) / 0.37 (0.36)
Level of care
General H / 10.69 (±8.5) / -0.5 (0.42) / 0 (0.45) / 49.13 (±9.1) / 0.33 (0.47) / 1.37 (0.48) / ** / 43.53 (±12.75) / 0.2 (0.64) / 0.69 (0.65)
Main H / 11.81 (±8.38) / -1.75 (0.46) / ** / -2.29 (0.46) / ** / 53.23 (±10.69) / 0.99 (0.58) / 2.18 (0.6) / ** / 48.83 (±11.7) / -0.67 (0.62) / 0.15 (0.62)
Max H / 9.12 (±7.28) / 0.87 (0.51) / -0.68 (0.52) / 57.52 (±9.34) / 1.49 (0.64) / * / 3.53 (0.68) / ** / 48.41 (±15.52) / -2.39 (0.91) / ** / -1.37 (1.05)
Uni H / 12.81 (±9.47) / -1.39 (0.57) / * / -1.96 (0.56) / ** / 71.19 (±16.12) / 0.03 (0.97) / 0.12 (0.99) / 48.58 (±11.43) / 1.67 (0.69) / * / 1.48 (0.65) / *
Specialty
General S / 11.26 (±7.79) / -0.93 (0.38) / * / -1.18 (0.39) / ** / 55.91 (±13.95) / 1 (0.71) / 2.36 (0.72) / ** / 50.94 (±12.42) / -0.42 (0.59) / 0.61 (0.6)
Trauma S / 13.28 (±9.21) / -0.59 (0.56) / 0.26 (0.56) / 59.2 (±14.28) / 1.31 (0.88) / 3.33 (0.9) / ** / 47.02 (±13.12) / -0.51 (0.79) / -0.41 (0.81)
Uro S / 13.02 (±8.1) / -1.52 (0.55) / ** / -2.3 (0.57) / ** / 59.92 (±12.94) / 0.53 (0.87) / 1.35 (0.88) / 45.1 (±14.54) / -0.54 (0.9) / 0.25 (0.97)
Ortho S / 9.91 (±8.5) / -0.27 (0.65) / -2.09 (0.62) / ** / 58.41 (±11.67) / 1.65 (0.86) / 2.45 (0.85) / ** / 45.45 (±11.1) / 0.86 (0.83) / 0.48 (0.8)
Ear-Nose S / 7.39 (±9.28) / -0.83 (0.75) / -2.29 (0.75) / ** / 48.17 (±13.79) / -0.05 (1.14) / 0.36 (1.12) / 42.33 (±10.76) / 0.45 (0.86) / 1.05 (0.85)
Note:** p<.01; * p<.05.
Hospital types: General H: general hospitals, Main H: main hospitals, Max H: maximum care hospitals, Uni H: universitymedical centers.
Specialties: General S: general surgery, Trauma S: trauma surgery, Uro S: urology, Ortho S: orthopedicsurgery, Ear-Nose S: ear-nose-throatsurgery.
1
Outcome / Overall / General H / Main H / Max H / Uni HLate starts (min) / Year (1) / -0.571 / * / -0.222 / -1.162 / ** / 0.062 / -0.516
(0.226) / (0.292) / (0.371) / (0.576) / (0.498)
Year (2) / -0.934 / ** / -0.161 / -1.119 / -0.553 / -1.542 / *
(0.318) / (0.443) / (0.585) / (0.865) / (0.636)
Intercept / 7.801 / ** / 6.063 / ** / 6.409 / ** / 7.000 / ** / 8.834 / **
(0.84) / (0.941) / (1.083) / (1.363) / (1.597)
adj. R2 / 0.7800 / 0.7690 / 0.7470 / 0.7588 / 0.8224
n / 14,409 / 4,128 / 5,007 / 2,182 / 3,092
N / 549 / 153 / 200 / 83 / 113
Turnover time (min) / Year (1) / 0.834 / ** / 0.647 / 0.908 / ** / 1.475 / ** / 0.493
(0.182) / (0.339) / (0.297) / (0.314) / (0.45)
Year (2) / 1.821 / ** / 1.348 / ** / 2.234 / ** / 3.318 / ** / 0.765
(0.293) / (0.446) / (0.506) / (0.66) / (0.739)
Intercept / 49.669 / ** / 42.402 / ** / 47.315 / ** / 49.110 / ** / 62.072 / **
(0.728) / (1.417) / (1.218) / (1.114) / (1.368)
adj. R2 / 0.9030 / 0.8457 / 0.8449 / 0.8786 / 0.8852
n / 14,422 / 4,135 / 5,018 / 2,174 / 3,095
N / 549 / 154 / 200 / 82 / 113
Rawutilization (%) / Year (1) / 0.027 / 0.291 / -0.401 / -0.992 / 0.975
(0.302) / (0.485) / (0.503) / (1.041) / (0.567)
Year (2) / 0.530 / 1.024 / -0.114 / -0.751 / 1.654
(0.478) / (0.808) / (0.741) / (1.713) / (0.906)
Intercept / 35.067 / ** / 31.944 / ** / 29.412 / ** / 33.689 / ** / 40.725 / **
(1.364) / (2.276) / (2.306) / (3.716) / (2.257)
adj. R2 / 0.7080 / 0.7324 / 0.7343 / 0.5899 / 0.7243
n / 14,256 / 4,111 / 4,963 / 2,147 / 3,035
N / 548 / 153 / 200 / 82 / 113
Note: ** p<.01; * p<.05. Additionalconfounders:average case duration (ACD), Months.
Hospital types: General H: general hospitals, Main H: main hospitals, Max H: maximum care hospitals, Uni H: universitymedical centers.
Latestarts
(min) / Year (1) / -0.571 / * / -0.804 / -0.067 / -0.602 / -0.797 / -0.553
(0.226) / (0.429) / (0.401) / (0.613) / (0.6) / (0.495)
Year (2) / -0.934 / ** / -1.372 / * / 0.714 / -1.658 / * / -1.492 / -0.973
(0.318) / (0.617) / (0.51) / (0.724) / (0.787) / (0.823)
Intercept / 7.801 / ** / 8.764 / ** / 8.490 / ** / 5.932 / ** / 9.749 / ** / 2.173
(0.84) / (2.136) / (0.867) / (1.016) / (1.408) / (1.249)
adj. R2 / 0.7801 / 0.6953 / 0.8510 / 0.7381 / 0.7672 / 0.7563
n / 14,409 / 4,310 / 3,297 / 2,104 / 2,607 / 2,091
N / 549 / 167 / 127 / 77 / 98 / 80
Turnover time (min) / Year (1) / 0.834 / ** / 0.695 / * / 1.104 / ** / 1.185 / ** / 0.754 / 0.415
(0.182) / (0.341) / (0.392) / (0.338) / (0.49) / (0.404)
Year (2) / 1.821 / ** / 1.910 / ** / 2.484 / ** / 2.470 / ** / 1.395 / 0.469
(0.293) / (0.515) / (0.605) / (0.581) / (1.066) / (0.543)
Intercept / 49.669 / ** / 49.289 / ** / 50.906 / ** / 51.612 / ** / 53.800 / ** / 42.585 / **
(0.728) / (1.032) / (1.83) / (1.727) / (1.642) / (0.907)
adj. R2 / 0.9028 / 0.8968 / 0.8947 / 0.8995 / 0.8265 / 0.9253
n / 14,422 / 4,314 / 3,298 / 2,117 / 2,599 / 2,094
N / 549 / 168 / 127 / 77 / 97 / 80
Rawutilization (%) / Year (1) / 0.027 / -0.307 / -0.052 / 0.351 / 0.148 / 0.308
(0.302) / (0.409) / (0.504) / (1.087) / (1.006) / (0.596)
Year (2) / 0.530 / 0.470 / 0.200 / 0.346 / 1.009 / 0.815
(0.478) / (0.742) / (0.763) / (1.248) / (1.765) / (0.924)
Intercept / 35.067 / ** / 33.464 / ** / 31.364 / ** / 39.274 / ** / 35.950 / ** / 32.772 / **
(1.364) / (2.018) / (2.951) / (2.82) / (2.412) / (5.687)
adj. R2 / 0.7084 / 0.7192 / 0.7510 / 0.6667 / 0.5827 / 0.7696
n / 14,256 / 4,271 / 3,224 / 2,101 / 2,581 / 2,079
N / 548 / 167 / 126 / 77 / 98 / 80
Note: ** p<.01; * p<.05. Additional confounders: average case duration (ACD), Months.
Specialties: General S: general surgery, Trauma S: trauma surgery, Uro S: urology, Ortho S: orthopedic surgery, Ear-Nose S: ear-nose-throat surgery.
1