Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.

Details

Serval ID
serval:BIB_3EC7C2A7DA49
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.
Journal
British Journal of Surgery
Author(s)
Roulin D., Donadini A., Gander S., Griesser A.C., Blanc C., Hübner M., Schäfer M., Demartines N.
ISSN
1365-2168 (Electronic)
ISSN-L
0007-1323
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
100
Number
8
Pages
1108-1114
Language
english
Notes
Publication types: Journal Article
Abstract
BACKGROUND: Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost-effectiveness of enhanced recovery implementation.
METHODS: The first 50 consecutive patients treated during implementation of an enhanced recovery programme were compared with 50 consecutive patients treated in the year before its introduction. The enhanced recovery protocol principally implemented preoperative counselling, reduced preoperative fasting, preoperative carbohydrate loading, avoidance of premedication, optimized fluid balance, standardized postoperative analgesia, use of a no-drain policy, as well as early nutrition and mobilization. Length of stay, readmissions and complications within 30 days were compared. A cost-minimization analysis was performed.
RESULTS: Hospital stay was significantly shorter in the enhanced recovery group: median 7 (interquartile range 5-12) versus 10 (7-18) days (P = 0·003); two patients were readmitted in each group. The rate of severe complications was lower in the enhanced recovery group (12 versus 20 per cent), but there was no difference in overall morbidity. The mean saving per patient in the enhanced recovery group was euro1651.
CONCLUSION: Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.
Pubmed
Web of science
Create date
26/07/2013 16:21
Last modification date
13/05/2020 5:22
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