Evidence map›Paper›PMID 39325047›Full record

ArticleInternational forum of allergy & rhinology2025

Time is money: An analysis of cost drivers in ambulatory sinus surgery.

David K Lerner, Chau Phung, Alan D Workman, Saawan Patel, Glenn Pennington, Robert Stetson, Jennifer E Douglas, Michael A Kohanski, James N Palmer, Nithin D Adappa

Abstract read
In one paragraph

Article in International forum of allergy & rhinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Moving Lumbar Drain Placement to IR From the Operating Room Creates Time and Cost Savings.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
    Article
  2. Time is money: An analysis of cost drivers in ambulatory sinus surgery.International forum of allergy & rhinology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

David K LernerDepartment of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, Florida, USA.ORCID 0000-0002-0431-2920
Chau PhungDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Alan D WorkmanDepartment of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.ORCID 0000-0001-9573-6472
Saawan PatelDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-3185-7026
Glenn PenningtonOffice of Strategic Decision Support, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Robert StetsonOffice of Strategic Decision Support, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jennifer E DouglasDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-3634-2067
Michael A KohanskiDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
James N PalmerDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nithin D AdappaDepartment of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

Immune function of bitter taste receptors in human macrophagesR01AI167971 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI Nithin Adappa, Robert J. Lee · 2022 to 2026
$2.5M
NIAID NIH HHS R01 AI167971NIH HHS AI167971
6 · The paper itself

Abstract

backgroundFunctional endoscopic sinus surgery (FESS) is one of the most commonly performed otolaryngologic procedures and is associated with significant cost variability.

methodsWe performed a retrospective analysis of all inflammatory sinus surgeries at a single tertiary care medical center from July 2021 to July 2023. The electronic medical record was reviewed for patient factors and cost variables for each procedure, and multivariable analysis was performed.

resultsA total of 221 patients were included in analysis with a mean age of 48.2 years. There was a 44.8% incidence (n = 99) of nasal polyps and 31.2% (n = 69) of cases were revision surgeries. The average total cost for the surgical encounter was $8960.31 (standard deviation $1967.97). Operating room time represented $4912.46 (54.8% of all costs), while average operating room supply costs were $1296.06 (14.5%) and recovery room costs were $919.48 (10.3%). Total costs were significantly associated with length of surgery ($7.83/min, p = 0.04), in addition to presence of nasal polyps ($531.96, p = 0.04). There was no significant association between total costs and the remaining clinical and demographic factors.

conclusionsCosts associated with ambulatory FESS for inflammatory sinus disease vary across patients and this cost variability is predominantly driven by time efficiency within the operating room, as well as supply utilization and nasal polyposis to a lesser degree. As a result, operating room efficiency represents a primary target for cost-related interventions. Additionally, our data provide a framework for surgeons and hospitals to make evidence-based decisions on intraoperative equipment in a tradeoff between efficiency and supply costs. Our findings indicate that an approach focused on streamlining efficiency across the entire ambulatory surgery encounter will have the greatest impact on reducing healthcare expenses for both the patient and the health system.

Indexed as

Ambulatory Surgical ProceduresEndoscopyHealth Care CostsNasal PolypsParanasal SinusesSinusitisAdultAgedFemaleHumansMaleMiddle AgedOperating RoomsRetrospective Studiesdelivery of health carehealthcare costshealthcare reformrhinosinusitissinus surgery

Identifiers

PMID39325047
PMCPMC11785154

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.