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How Expensive is ENT Surgeons' Involvement in Retrosigmoid Craniotomies? A Time-Driven Activity-Based Cost Analysis
Journal article   Open access   Peer reviewed

How Expensive is ENT Surgeons' Involvement in Retrosigmoid Craniotomies? A Time-Driven Activity-Based Cost Analysis

Danyal A. Quraishi, D. Mitchell Self, Steven Glener, Advith Sarikonda, Neerav Kumar, Emily L. Isch, Matthews Lan, Arbaz Momin, Ashmal Sami Kabani, James J. Evans, …
Journal of neurological surgery. Part B, Skull base, v 87(3), pp e65-e74
22 May 2025
DOI: https://doi.org/10.1055/a-2607-0611
PMID: 42095035
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
ttps://pmc.ncbi.nlm.nih.gov/articles/PMC13143384/View
Submitted Open PubMed Central

Abstract

cost-effectiveness ENT collaboration retrosigmoid craniotomy time-driven activity-based costing
Objective This study aims to examine the impact of ear, nose, and throat (ENT) surgeons' involvement on intraoperative costs and operating room (OR) times for retrosigmoid craniotomies using time-driven activity-based costing (TDABC). Design A retrospective, single-center analysis was conducted. TDABC methodology was utilized to calculate total intraoperative costs. Multiple linear regression analysis was performed to assess the independent effect of ENT surgeons' involvement on surgical costs and OR time. Setting All procedures were performed at the Thomas Jefferson University Hospital and affiliated sites between 2017 and 2022. Participants About 255 patients underwent retrosigmoid craniotomy (166 neurosurgery only, 89 with ENT surgeons' involvement). Main Outcome Measures Main outcome measures include total intraoperative costs calculated using TDABC methodology, OR time, supply costs, and personnel costs. Results Inclusion of ENT surgeons was significantly associated with increased total costs (B = $4,082 ± $1,015, p < 0.001) and OR time (B = 135 ± 38 minutes, p < 0.001). The mean total cost of neurosurgery-only cases was $7,538 ± $3,977, compared with $14,217 ± $3,485 for multidisciplinary cases. Personnel costs were the primary driver of this increase, with no significant difference in supply costs between groups. Conclusion While ENT collaboration can enhance outcomes in select cases, such as those involving vestibular schwannomas, its routine inclusion may not be cost-effective. Our study demonstrates the marginal cost of ENT collaboration for retrosigmoid craniotomies. Future studies may build on our costing framework by integrating outcomes with costs to determine the true cost-effectiveness of cross-specialty collaboration.

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Surgery
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