Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery

Roulin, Didier; Donadini, Andrea; Gander, Sylvain; Griesser, Anne-Claude; Blanc, Catherine; Hübner, Martin; Schäfer, Markus; Demartines, Nicolas

doi:10.1002/bjs.9184

Cited by 253 publications

(207 citation statements)

References 26 publications

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“…A comprehensive analysis of all real costs was performed for every patient according to a method previously used by our group [3]. Briefly, all pertinent intraoperative costs and pre-/postoperative costs were considered.…”

Section: Analysis Of the Costsmentioning

confidence: 99%

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

et al. 2016

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Section: Analysis Of the Costsmentioning

confidence: 99%

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

et al. 2016

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“…[1][2][3][4][5][6][7] It is well docu mented that ERAS is clinically effective as well as costeffective/cost-saving in that it reduces complications and health services utilization (HSU; e.g., length of stay in hospital [LOS]) without compromising patient safety and health-related quality of life (HRQoL). [8][9][10][11] A recent metaanalysis of 16 randomized controlled trials shows that ERAS significantly decreases primary LOS by 2.28 days and risk of complications by 40% in patients undergoing colorectal surgery.…”

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confidence: 99%

An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta

Thanh

Chuck

Wasylak

et al. 2016

cjs

114

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Background: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. Methods:We assessed the impact of ERAS on patients' health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre-and post-ERAS groups using multilevel negative binomial regressions. We estimated the net health care costs/savings and the return on investment (ROI) associated with those impacts for post-ERAS patients using a decision analytic modelling technique. Results:We included 331 pre-and 1295 post-ERAS patients in our analyses. ERAS was associated with a reduction in all HSU outcomes except visits to specialists. However, only the reduction in primary LOS was significant. The net health system savings were estimated at $2 290 000 (range $1 191 000-$3 391 000), or $1768 (range $920-$2619) per patient. The probability for the program to be cost-saving was 73%-83%. In terms of ROI, every $1 invested in ERAS would bring $3.8 (range $2.4-$5.1) in return. Conclusion:The initial phase of ERAS implementation for colorectal surgery in Alberta is cost-saving. The total savings has the potential to be more substantial when ERAS is spread for other surgical protocols and across additional sites.Contexte : En février 2013, les Services de santé de l'Alberta ont mis en place le programme ERAS (Enhanced Recovery After Surgery -récupération postchirurgicale améliorée) dans le but de faire adopter les lignes directrices en matière d'interventions colorectales de la ERAS Society à 6 établissements (première phase) où sont pratiquées plus de 75 % des interventions chirurgicales colorectales de la province. Nous avons réalisé une évaluation économique du programme, non seulement pour en mesurer la rentabilité, mais aussi pour élaborer une stratégie visant à étendre le programme ERAS à d'autres protocoles chirurgicaux et services de chirurgie.Méthodes : Nous avons mesuré les effets du programme ERAS sur l'utilisation des services de santé (durée de séjour, réadmissions, visites au service des urgences, visites d'un omnipraticien ou d'un spécialiste) dans les 30 jours suivant le congé en comparant les groupes pré-et post-ERAS à l'aide de régressions binomiales négatives multiniveaux. Nous avons évalué le coût net des soins de santé, les économies réalisées et le rendement sur investissement (RSI) associés aux mesures ci-dessus chez les patients post-ERAS à l'aide d'une technique de modélisation analytique décisionnelle.Résultats : Nos analyses ont porté sur 331 patients pré-ERAS et 1295 patients post-ERAS. Nous avons observé une...

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“…The FTS pathway has been used successfully in urological, 3,4 orthopaedic, 5 gynaecological 6,7 and, especially, colonic 8,9 settings. For colorectal surgery, a working group developed and modified a consensus guideline for FTS programmes in 2009.…”

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confidence: 99%

A meta-analysis of fast track surgery for patients with gastric cancer undergoing gastrectomy

Chen

Huang

et al. 2015

annals

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Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery

Abstract: Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.

Cited by 253 publications

References 26 publications

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

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

An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta

A meta-analysis of fast track surgery for patients with gastric cancer undergoing gastrectomy

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