Economic impact of an enhanced recovery pathway for oesophagectomy.
نویسندگان
چکیده
BACKGROUND Data are lacking to support the cost-effectiveness of enhanced recovery pathways (ERP) for oesophagectomy. The aim of this study was to investigate the impact of an ERP on medical costs for oesophagectomy. METHODS This study investigated all patients undergoing elective oesophagectomy between June 2009 and December 2011 at a single high-volume university hospital. From June 2010, all patients were enrolled in an ERP. Clinical outcomes were recorded for up to 30 days. Deviation-based cost modelling was used to compare costs between the traditional care and ERP groups. RESULTS A total of 106 patients were included (47 traditional care, 59 ERP). There were no differences in patient, pathological and operative characteristics between the groups. Median length of hospital stay (LOS) was lower in the ERP group (8 (interquartile range 7-18) days versus 10 (9-18) days with traditional care; P = 0·019). There was no difference in 30-day complication rates (59 per cent with ERP versus 62 per cent with traditional care; P = 0·803), and the 30-day or in-hospital mortality rate was low (3·8 per cent, 4 of 106). Costs in the on-course and minor-deviation groups were significantly lower after implementation of the ERP. The pathway-dependent cost saving per patient was €1055 and the overall cost saving per patient was €2013. One-way sensitivity analysis demonstrated that the ERP was cost-neutral or more costly only at extreme values of ward, operating and intensive care costs. CONCLUSION A multidisciplinary ERP for oesophagectomy was associated with cost savings, with no increase in morbidity or mortality.
منابع مشابه
Hydraulic Fracturing Length Optimization and its Impact on the Reservoir Performance
Hydraulic fracturing is one of the most common methods of well stimulation for reservoirs with low permeability. Hydraulic fracturing increases the flow capacity, alters flow geometry, bypasses damage and improves recovery factor. The pressure of most of Iranian oil reservoirs is declined and consequently the production is reduced. It is necessary to improve the production by using new stimulat...
متن کاملAchieving long term survival in oesophagectomy patients aged over 75
AIMS Surgical resection is often the only curative treatment for oesophageal cancer. The aim of this retrospective cohort study was to analyse outcomes following oesophageal resection in patients aged 75 years and older and the impact of an Enhanced Recovery after Surgery (ERAS) program in this cohort. METHODS Patients aged over 75 years undergoing oesophagectomy between 2003 and 2013 were id...
متن کاملApplication of Nanoparticles for Chemical Enhanced Oil Recovery
In this paper, the potentials of using particles, especially nanoparticles, in enhanced oil recovery is investigated. The effect of different nanoparticles on wettability alteration, which is an important method to increase oil recovery from oil-wet reservoirs, is reviewed. The effect of different kinds of particles, namely solid inorganic particles, hydrophilic or hydrophobic nanoparticles, an...
متن کاملTranslation of guidelines for perioperative care in gynecologic/oncology: enhanced recovery after surgery (ERAS) society recommendations-2019 update
Background: Enhanced recovery after surgery (ERAS) is now firmly established as a global surgical quality improvement initiative that results in both clinical improvements and cost benefits to the healthcare system. ERAS guidelines are based on the highest quality evidence available and as such require updating on a regular basis. The ERAS Gynecologic/Oncology guidelines were first published in...
متن کاملStudy protocol for the nutritional route in oesophageal resection trial: a single-arm feasibility trial (NUTRIENT trial)
INTRODUCTION The best route of feeding for patients undergoing an oesophagectomy is unclear. Concerns exist that early oral intake would increase the incidence and severity of pneumonia and anastomotic leakage. However, in studies including patients after many other types of gastrointestinal surgery and in animal experiments, early oral intake has been shown to be beneficial and enhance recover...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The British journal of surgery
دوره 100 10 شماره
صفحات -
تاریخ انتشار 2013