Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_B1D655A188E3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.
Journal
World Journal of Surgery
Author(s)
Joliat G.R., Labgaa Ismail, Hübner M., Blanc C., Griesser A.C., Schäfer M., Demartines N.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
40
Number
10
Pages
2441-2450
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery.
METHODS: A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed.
RESULTS: Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were euro38,726 and euro42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of euro3080 per patient after ERAS implementation.
CONCLUSIONS: ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.
Pubmed
Web of science
Open Access
Yes
Create date
18/06/2016 17:18
Last modification date
10/02/2024 7:14
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