COSTS INCURRED BY OUTPATIENT SURGICAL CENTERS IN MANAGING POSTOPERATIVE NAUSEA AND VOMITING

Study Objective: To estimate the financial costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting (PONV). Design: Prospective, observational study. Setting: 6 hospital-based outpatient surgery centers. Patients: 211 adult patients undergoing outpatient surgery for laparoscopy, dilatation and curettage, knee arthroscopy, or hernia repair. Measurements and Main Results: Of the 211 patients studied, 34 experienced PONV in the recovery room. For those patients experiencing PONV, personnel, supply, and drug costs for management of this condition averaged $14.94 per patient. In addition, PONV increased the centers' operating costs by delaying patient discharge by an average of 24 minutes. A minimum estimate of this cost, based on nurses' wage rates, was $7.12. This estimate is appropriate only for short-run considerations in outpatient surgery centers that operate at low capacity. An appropriate valuation for long-run considerations and for centers operating near capacity is based on the revenue that centers lose as a result of extended stays. Lost revenue was estimated to be $415 per patient experiencing PONV. Conclusions: PONV substantially increases the costs incurred by outpatient surgical centers.