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Weekend ECRP saved inpatients money, reduced lengths of stay
Making it easier to schedule endoscopic retrograde cholangiopancreatography procedures during weekends, instead of waiting until the following Monday, helped to reduce hospital patients’ lengths of stay and reduced patient charges, according to a recent study.
In a retrospective review, 123 endoscopic retrograde cholangiopancreatography (ERCP) procedures between May 2010 and September 2011 — 52 performed on a weekend and 71 on a Monday, excluding patients who were admitted on a Monday — were examined. There were no significant demographic differences between the weekend and Monday groups of patients (mean age, 56.3 years; 54.5 % female; 60.2% Caucasian). The majority of indications were choledocholithiasis (34.9%) and elevated liver enzymes after liver transplantation (25.2%).
Analysis showed a reduction in length of stay (P=.01) and a trend toward reduced costs (P=.05), and lower propensity-score adjusted odds of a length of stay greater than 3 days (OR=0.37; 95% CI, 0.16–0.85) with a weekend procedure vs. a Monday procedure.
Weekend procedures averaged a 3-day length of stay, while Monday procedures averaged 6 days, caused by fewer days between inpatient admission (P=.002) or consultation (P=.007) and ERCP.
Patients who underwent ERCP on weekends also saved about $18,000 in inpatient charges, seeing charges on average of $38,002, compared with $56,258 for patients who underwent the procedures on Mondays.
There were no significant differences in adverse events between patients who underwent weekend ERCP vs. Monday ERCP (1.9% vs. 2.8 %; P=.65).
Given efforts to reduce both lengths of stay and patient costs, adding incentives and removing hurdles for weekend procedures, both ERCP and otherwise, could be worthwhile, the researchers said.
“Although our study applies to ERCPs only, performance of other inpatient procedures on the weekends may also yield similar results,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.