Economic Performance of a Center for Microsurgery and Complex Reconstruction at an Academic Medical Center

Economic pressures have strongly influenced the development of reconstructive surgery, with a long trend of decreasing numbers of reconstructive surgery practices and procedures associated with decreasing reimbursements. Previously, these authors have reported an analysis model to evaluate the financial impact of reconstructive cases on hospital revenues, with the added premise, that if profits existed, they could be partially used to support and further develop reconstructive practice. They have applied this model to assess the performance of an operational reconstructive surgery center.

In April 2001, the University of Mississippi established the Center for Microsurgery and Complex Reconstruction. The authors have analyzed the cases managed in the Center, including microsurgical flaps, replants, nerve reconstruction, secondary and associated cases. During the same time period, financial data were also analyzed for non-Center plastic surgery cases (cosmetic, breast reduction, etc.) and inpatient consults. Data consisted of actual hospital income, direct costs, indirect costs, and calculated profit (or loss).

Center cases showed a sustained hospital profit of greater than 20% of gross revenue over a 2-year period. Routine cases were unprofitable, while losses associated with inpatient consults decreased over the same period. The decreased losses with consults may be related to a very visible and active reconstructive surgery consult service. This analysis was able to specify the impact of specialty cases on hospital revenue. In this study, specialty reconstructive cases were shown to be profitable. This kind of analysis can be used to identify hospital revenues related to specific patient groups and make cases for practice development support.