Table A13: Vein stripping surgery resources – estimates from a vascular surgeon #1 in Toronto.
| Resources | Unit | Unit Cost | Utilization 1 | Cost 1 | Assumptions | References |
|---|---|---|---|---|---|---|
| Day Surgery | ||||||
| Hospital | per case | $1,058.72 | 1 | $1,058.72 | Procedure: 1KR87LA,1KR87LAXXA,1KR87WK,1 KR87WKXXA,1KR87WM - see vein stripping spreadsheet for details on costing | Canadian Classification of Health Interventions - ICD-10-CA/CCI, Version 2006 License Agreement for CD; Accessed November 2009; The Ontario Case Costing Initiative - www.occp.com; accessed October/November 2009; Last updated September 2009. |
| Medical Visits | ||||||
| Vascular surgeon | per consult | $132.50 | 1 | $132.50 | Assumed that procedural visits are billed to the province separately and not absorbed by the hospital/clinic procedural cost; assumed 1 consult and visit pre, 1 labour, 1 visit post. | Vascular surgeon in Toronto; OSB A935 http://www.health.gov.on.ca/english/providers/program/ohip/sob/physserv/physserv_mn.html, Last updated September 2009, Accessed November 2009 |
| Long saphenous veins | per labour | $148.60 | 1 | $148.60 | 100% of the time R868 plus R837; R869 would be a minority (~10 to 15% as an isolated procedure); Recurrent veins occur in anywhere from 20 to 50% of patient after vein stripping, some would say an even higher percentage. | Vascular surgeon in Toronto; OSB R868 |
| Phlebectomy | per labour | $148.60 | 1 | $148.60 | OSB R837 | |
| Short saphenous veins | per labour | $107.50 | 1 | $107.50 | OSB R869 | |
| Recurrent veins | per labour | $353.80 | 1 | $353.80 | OSB R844 | |
| per visit | $29.20 | 2 | $58.40 | OSB C092 | ||
| Anesthetist | per consult | $103.85 | 1 | $103.85 | Assumed that procedural visits are billed to the province separately and not absorbed by the hospital/clinic procedural cost; assumed 1 consult pre and 1 labour. | Vascular surgeon in Toronto; OSB A015 |
| per labour | $119.16 | 1 | $119.16 | Assumed 2 hour surgery, therefore base units plus 1 unit in the first hour and 2 units after the first hour up to and including the first 1.5 hours. | Vascular surgeon in Toronto; OSB R868 | |
| per labour | $119.16 | 1 | $119.16 | Vascular surgeon in Toronto; OSB R837 | ||
| per labour | $119.16 | 1 | $119.16 | Vascular surgeon in Toronto; OSB R869 | ||
| per labour | $119.16 | 1 | $119.16 | Vascular surgeon in Toronto; OSB R844 | ||
| Surgical assistant | per labour | $102.60 | 1 | $102.60 | Assumed that procedural visits are billed to the province separately and not absorbed by the hospital/clinic procedural cost; assumed 1 labour; assumed 2 hour surgery therefore base units plus 1 unit in the first hour and 2 units after the first hour. | Vascular surgeon in Toronto; OSB R868 |
| per labour | $102.60 | 1 | $102.60 | Vascular surgeon in Toronto; OSB R837 | ||
| per labour | $102.60 | 1 | $102.60 | Vascular surgeon in Toronto; OSB R869 | ||
| per labour | $102.60 | 1 | $102.60 | Vascular surgeon in Toronto; OSB R844 | ||
| GP | per consult | $56.10 | 1 | $56.10 | Assumed that procedural visits are billed to the province separately and not absorbed by the hospital/clinic procedural cost; assumed 1 consult and 1 visit post. | Vascular surgeon in Toronto; OSB C005 |
| per visit | $29.20 | 1 | $29.20 | OSB C002 | ||
| Nurse | per visit | $32.73 | 1 | $32.73 | Assumed that procedural visits are billed to the province separately and not absorbed by the hospital/clinic procedural cost; assumed 1 post-op hour visit by a nurse. | Vascular surgeon in Toronto; http://www.health.gov.on.ca/transformation/fht/guides/fht_inter_provider.pdf, Last updated May 2009, Accessed November 2009 |
| Laboratory Tests | ||||||
| CBC | per test | $ 8.27 | 2 | $ 16.54 | Assumed all tests during visit are absorbed by hospital cost per case; assumed one pre and 1 post test. | Vascular surgeon in Toronto; OSLF L393 http://www.health.gov.on.ca/english/providers/program/ohip/sob/lab/lab_mn.html, Last updated June 2009, Accessed November 2009 |
| Electrolytes (3 tests: Cl, K and Na) |
per test | $ 7.76 | 1 | $ 7.76 | Assumed all tests during visit are absorbed by hospital cost per case; assumed one pre test. | Vascular surgeon in Toronto; OSLF L053, L204, L226 |
| BUN | per test | $ 2.59 | $ - | |||
| Creatinine | per test | $ 2.59 | $ - | |||
| Medical Procedures | ||||||
| Duplex venous imaging | per technical test | $34.35 | 1 | $34.35 | Assumed all tests during visit are absorbed by hospital cost per case; assumed one pre test. | Vascular surgeon in Toronto; OSB J202 |
| per professional test | $21.40 | 1 | $21.40 | |||
| Bilateral | per technical test | $7.60 | 1 | $7.60 | Vascular surgeon in Toronto; OSB J198 | |
| per professional test | $12.70 | 1 | $12.70 | |||
| Chest x-ray (3 views or more) |
per technical test | $28.85 | 1 | $28.85 | Assumed all tests during visit are absorbed by hospital cost per case; assumed one pre test. | Vascular surgeon in Toronto OSB X092 |
| per professional test | $12.80 | 1 | $12.80 | |||
| Electrocardiogram | per technical test | $6.75 | 1 | $6.75 | Assumed all tests during visit are absorbed by hospital cost per case; assumed one pre test. | Vascular surgeon in Toronto; OSB G310 |
| per professional test | $9.75 | 1 | $9.75 | OSB G313 | ||
| Ultrasound doppler | per technical test per professional test |
$22.60 $18.40 |
$ - $ - |
|||
| Bilateral | per technical test per professional test | $7.60$12.70 | ||||
| Drugs | ||||||
| Tylenol 3 (30 mg) | per tablet | $0.05 | 168 | $8.80 | Assumed all drugs during visit are absorbed by hospital cost per case; assumed 240 mg codeine per day for 3 weeks post. | Vascular surgeon in Toronto; ODB formulary https://www.healthinfo.moh.gov.on.ca/formulary/SearchServlet, Last updated April 2009, Accessed November 2009 |
| Keflex (500 mg) | per tablet | $0.47 | 21 | $9.95 | Assumed all drugs during visit are absorbed by hospital cost per case; assumed 1-2 gms PO per day for 7 days post. | Vascular surgeon in Toronto; ODB formulary https://www.healthinfo.moh.gov.on.ca/formulary/SearchServlet, Last updated April 2009, Accessed November 2009 |