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Enhanced recovery program reduces colorectal surgery costs
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An enhanced recovery pathway for patients who underwent elective colorectal surgery resulted in lower hospital costs in addition to better outcomes, according to a new study published in the Journal of the America College of Surgeons.
Enhanced recovery pathways (ERP) are a standardized policy for managing patients before, during and after surgery. Ian M. Paquette, MD, FACS, associate professor of surgery at the University of Cincinnati College of Medicine, and colleagues wrote that high pharmaceutical costs remain a barrier to widespread acceptance of ERP regimens despite their apparent success.
“The enhanced recovery protocol provides clinical benefits by allowing surgical patients to recover quicker, use less narcotic medication and have a smoother recovery that gets them out of the hospital and hopefully back to work sooner,” Paquette said in a press release. “This study shows that there is a financial benefit from using the standardized pathway as well.”
Paquette and colleagues compared outcomes and costs of one group of patients who underwent colorectal surgery before ERP implementation (n = 160) vs. another group that underwent surgery after the program began (n = 146).
After adopting the ERP, median length of stay shortened from 5 days to 3 days (P < .01). Even though the daily pharmacy cost was higher in the ERP group ($477 vs. $18), the total pharmacy cost over the course of their hospitalization was lower ($1,534 vs. $1,859, P = .016).
Patients in the ERP group also needed less narcotics during their hospital stay (211.7 vs. 720.2 morphine equivalence units, P < .01). There was no difference in 30-day complications or hospital readmission.
Paquette and colleagues concluded that implementing ERP for patients who undergo colorectal surgery can reduce costs by shortening the length of hospitalization without increasing complications.
“The evidence is overwhelming that [ERPs] lead to a better recovery, get patients back to a normal lifestyle in a quicker manner and minimize the amount of narcotics, which may help with the ongoing opioid epidemic,” Paquette said in the press release. “This study shows they also lower hospital costs.” – by Alex Young
Disclosures: The authors reported no relevant financial disclosures.
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