# A Survey of the Estimated Cost of Surgical Consumable Items Within Trauma and Orthopaedic Departments

## TL;DR

This study shows that Trauma and Orthopaedic department staff have limited knowledge about the actual costs of surgical consumables, with only a small percentage of cost estimates being accurate.

## Contribution

The paper provides a survey-based assessment of cost-awareness among T&O staff, revealing a lack of knowledge about consumable item costs.

## Key findings

- Only 7.1% of all item cost estimates were correct.
- Kenalog 1 mL ampoule had the highest estimation accuracy (13%), while kirschner wires and 3.2 drill bit had the lowest (4% each).
- Tourniquet cuffs were the most underestimated item, with a median estimate/actual cost ratio of 0.16.

## Abstract

Introduction

The impact of the current economic and environmental climate, both nationally and globally, is further straining the NHS. This has led to scrutiny of high-expenditure areas, including consumables. Clinician’s knowledge surrounding health economics is sparse, and we conducted this survey to assess cost-awareness within the Trauma and Orthopaedic (T&O) departmental staff.

Methods

A questionnaire was digitally distributed to T&O staff in the East Kent Hospitals Trust. This included demographic data and to make estimations of the cost of 10 specialty-specific items. The data were analysed to determine the average, median, and interquartile range (IQR) of the estimated prices and compared to the actual costs.

Results

Approximately 7.1% of all item estimates were deemed ‘correct’. No correlation was seen between years of staff experience and the accuracy of estimates. ‘Kenalog 1 mL ampoule’ (Kenalog, Bristol-Myers Squibb, NJ) had the highest accuracy of estimation across all responses (13%), whilst both ‘kirschner wires’ and ‘3.2 drill bit’ had the lowest accuracy (4% each). The median estimated cost was closest to the actual cost for ‘cement pack’ (median estimate/actual cost = 0.9). The median estimated cost was furthest from the actual cost for ‘tourniquet cuffs’ (median estimate/actual cost = 0.16). ‘Velcro wrist splint’ was the item that was the most overestimated (median estimate/actual cost = 1.57), with only two of the 10 items being overestimated (‘velcro wrist splint’ and ‘dynamic hip screw and plate’). The most underestimated item was ‘tourniquet cuffs’ (median estimate/actual cost = 0.16).

Conclusions

There is a paucity of knowledge surrounding the cost of specialist T&O consumables. The limitations included the sample size (98 respondents) and geographical area (East Kent Hospitals Trust). This study shows that there is a need for further research into this topic, with long-term outcomes, which may be beneficial both economically and environmentally.