Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy.

Details

Serval ID
serval:BIB_B06B9225B385
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy.
Journal
British Journal of Surgery
Author(s)
Joliat G.R., Labgaa I., Petermann D., Hübner M., Griesser A.C., Demartines N., Schäfer M.
ISSN
1365-2168 (Electronic)
ISSN-L
0007-1323
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
102
Number
13
Pages
1676-1683
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Enhanced recovery after surgery (ERAS) programmes have been shown to decrease complications and hospital stay. The cost-effectiveness of such programmes has been demonstrated for colorectal surgery. This study aimed to assess the economic outcomes of a standard ERAS programme for pancreaticoduodenectomy.
METHODS: ERAS for pancreaticoduodenectomy was implemented in October 2012. All consecutive patients who underwent pancreaticoduodenectomy until October 2014 were recorded. This group was compared in terms of costs with a cohort of consecutive patients who underwent pancreaticoduodenectomy between January 2010 and October 2012, before ERAS implementation. Preoperative, intraoperative and postoperative real costs were collected for each patient via the hospital administration. A bootstrap independent t test was used for comparison. ERAS-specific costs were integrated into the model.
RESULTS: The groups were well matched in terms of demographic and surgical details. The overall complication rate was 68 per cent (50 of 74 patients) and 82 per cent (71 of 87 patients) in the ERAS and pre-ERAS groups respectively (P = 0·046). Median hospital stay was lower in the ERAS group (15 versus 19 days; P = 0·029). ERAS-specific costs were euro922 per patient. Mean total costs were euro56 083 per patient in the ERAS group and euro63 821 per patient in the pre-ERAS group (P = 0·273). The mean intensive care unit (ICU) and intermediate care costs were euro9139 and euro13 793 per patient for the ERAS and pre-ERAS groups respectively (P = 0·151).
CONCLUSION: ERAS implementation for pancreaticoduodenectomy did not increase the costs in this cohort. Savings were noted in anaesthesia/operating room, medication and laboratory costs. Fewer patients in the ERAS group required an ICU stay.
Keywords
Aged, Cost-Benefit Analysis, Female, Follow-Up Studies, Health Care Costs, Humans, Length of Stay/economics, Male, Middle Aged, Pancreaticoduodenectomy/economics, Postoperative Care/economics, Postoperative Period, Prospective Studies, Recovery of Function
Pubmed
Web of science
Create date
31/12/2015 11:15
Last modification date
20/08/2019 15:19
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