Effect of provider volume on resource utilization for surgical procedures of the knee

Nitin Jain, Ricardo Pietrobon, Ulrich Guller, Anoop Shankar, Ajit S. Ahluwalia, Laurence D. Higgins

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Operating-room time and patient disposition on discharge are important determinants of healthcare resource utilization and cost. We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament (ACL) reconstruction and meniscectomy procedures. Patients undergoing ACL reconstruction (18,390 cases) and meniscectomy (123,012 cases) were extracted from the State Ambulatory Surgery Databases for the years 1997-2000. Surgeon and hospital volume were divided into low-, intermediate-, and high-volume categories. Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operating-room time. Patients undergoing ACL reconstruction or meniscectomy performed by low-volume surgeons were significantly more likely to be non-routinely discharged as compared to high-volume surgeons (adjusted odds ratio 3.5, 95% confidence interval 1.7-7.2 for ACL reconstruction; adjusted odds ratio 2.0, 95% confidence interval 1.6-2.3 for meniscectomy). The mean operating-room time for performing ACL reconstruction or meniscectomy was significantly higher in low- and intermediate-volume surgeons and hospitals as compared to high-volume surgeons and hospitals (p≤0.001). High-volume providers utilize healthcare resources more efficiently. Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinely-performed ambulatory surgery procedures.

Original languageEnglish (US)
Pages (from-to)302-312
Number of pages11
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number4
StatePublished - May 2005
Externally publishedYes


  • Anterior cruciate ligament reconstruction
  • Healthcare utilization project
  • Meniscectomy
  • Operating-room time
  • Resource utilization

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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