**5.2 Financial considerations**

Building a hybrid operating room is a considerable economic investment for every hospital. Sound business models and optimal usage of the room are prerequisites to make this endeavour a financial success.

### **5.2.1 Costs**

The costs for hybrid rooms vary considerably depending on whether or not re- or new construction is necessary.

Furthermore, it may be necessary to hire additional staff such as radiology technicians that are familiar with interventional imaging systems. Both new and existing staff may require outside training to be able to use the equipment properly. These decisions depend on the existing knowledge in the hospital and on what procedures will be performed.

A recent study (Neumann, 2009) compared the investment necessary for hybrid suites, cath labs and standard ORs. Room size, construction requirements, angiography system, other equipment, depreciation, maintenance and debt service were taken into account. Overall, investment costs for the standard OR were lowest, followed by the cath lab with a 25% higher price tag. The costs for a hybrid OR were additional 120% of the costs of the standard OR. When comparing the operating costs (maintenance, depreciation, debt service and rent) the same relations applied. The costs for the cath lab were 25% higher than for the OR. Comparing the OR with the hybrid OR, an additional 90% were required per annum.

These figures may differ, depending on system choice, building costs and local requirements but the above mentioned figures give a good indication on the comparative costs. Taking these reasonably high costs into account, the obvious question arises how a hybrid OR can be a profitable investment.
