Cost-analysis of Enhanced Recovery After Surgery (ERAS) Program in Gynecologic Surgery

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State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_5A3C6418CD6F
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Cost-analysis of Enhanced Recovery After Surgery (ERAS) Program in Gynecologic Surgery
Author(s)
PACHE Basile
Director(s)
Mathevet Patrice
Codirector(s)
Hubner Martin
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2019
Language
english
Abstract
Objectives. Enhanced recovery after surgery (ERAS) programs has shown clinical benefits in gynecologic sur- gery. The aim of the present study was to compare costs before and after implementation of an ERAS program for gynecologic surgery.
Methods. Retrospective study comparing perioperative costs between consecutive patient groups under- going gynecologic surgery (benign, staging or debulking) (I, 2012-13) prior, (II) immediately after, and (III, 2014-16) the three years after ERAS implementation. Preoperative, intraoperative, and postoperative real costs were collected for each patient via hospital administration. A bootstrap independent t-test was used for comparison.
Results. Demographics and preoperative characteristics were similar between group I (n = 42), II (n = 51), and III (ERAS I; n = 122, II; n = 134, III; n = 90). Average ERAS-specific costs were $687 per patient. Total mean individual costs per patient were $13′329 (95% confidence interval (CI): 11’301-15’213) and
$17’710 (95% CI: 14′452–21′605) in the ERAS and pre-ERAS groups respectively, resulting in net savings of $4′381 (95% CI: 549–8’752, p = 0.043) in favour of ERAS group. Cost savings were explained by lower pre- and postoperative costs (difference: $5’011 95% CI: 1’587–8’998, p = 0.019).
Total costs continued to decrease by $2′520 (mean: $15’190, 95% CI: 13’791–16’631) in year 1, by $3’077 (mean: $14’633, 95% CI: 13’378–16’250) and $5’070 (mean: $12’640, 95% CI: 11’460–14’015) (p = 0.03) re-
spectively, in year 2 and 3 after implementation.
Conclusion. Based on real costs and including specific costs due to ERAS implementation, ERAS program in gynecologic surgery induced significant decrease of overall costs by $4’381 per patient. Total costs con- tinued to decrease in the three years after implementation.
Create date
10/12/2019 13:03
Last modification date
07/01/2020 12:16
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