A ZERO TOLERANCE FOR OVERTIME INCREASES SURGICAL PER CASE COSTS

Purpose: One technique which some hospitals have used in an attempt to control Operating Room costs is a ''zero tolerance Tor overtime'' pol icy. We used a case cost analysis to determine if this policy was alwa ys cost. effective. Method: A case cost analysis was designed based on a ''test case'' which would start late in the day. The case would las t for three hours of which 1-1/2 hr would be during regular hours, and 1-1/2 hr would incur overtime, Costs were analysed using a ''patient pays,'' ''society pays'' and ''hospital pays'' analysis. Costs were ba sed on figures determined from the SMBD-Jewish General Hospital budget , Quebec Health Insurance fees, and Government of Canada statistics.Re sults: Regardless of who pays, in this case scenario it was more cost effective to proceed than to postpone surgery. Costs of proceeding wit h the surgery in the ''patient pays, ''society pays,'' and ''hospital pays'' models were $1,832.00, $1,227.40, and $1,215.00 respectively. T he costs of postponing the surgery in the same three models were $1,93 7.00, $1,336.80, and $1,436.00. Conclusion: A ''zero tolerance for ove rtime'' policy may be too rigid to be consistently cost effective.