Economic Impact of the Implementation of an Enhanced Recovery after Surgery (ERAS) Protocol in a Bariatric Patient Undergoing a Roux-En-Y Gastric Bypass

Abstract

Introduction: Enhanced Recovery After Surgery (ERAS) protocols have proven to be cost-effective in various surgical procedures, mainly in colorectal surgeries. However, there is still little scientific evidence evaluating the economic impact of their application in bariatric surgery. The present study aimed to compare the economic cost of performing a laparoscopic Roux-en-Y gastric bypass following an ERAS protocol, with the costs of following a standard-of-care protocol. Patients and methods: A prospective non-randomized study of patients undergoing Roux-en-Y gastric bypass was performed. Patients were divided into two groups: patients following an ERAS protocol and patients following a standard-of-care protocol. The total costs of the procedure were subdivided into pharmacological expenditures, surgical material, and time expenses, the price of complementary tests performed during the hospital stay, and costs related to the hospital stay. Results: The 84 patients included 58 women (69%) and 26 men (31%) with a mean age of 44.3 ± 11.6 years. There were no significant differences in age, gender, and distribution of comorbidities between groups. Postoperative pain, nausea or vomiting, and hospital stay were significantly lower within the ERAS group. The pharmacological expenditures, the price of complementary tests performed during the hospital stay, and the costs related to the hospital stay, were significantly lower in the ERAS group. There were no significant differences in the surgical material and surgical time costs between groups. Globally, the total cost of the procedure was significantly lower in the ERAS group with a mean saving of 1458.62$ per patient. The implementation of an ERAS protocol implied a mean saving of 21.25% of the total cost of the procedure. Conclusions: The implementation of an ERAS protocol significantly reduces the perioperative cost of Roux-en-Y gastric bypass.

Composition And Influencing Factors of Hospital Expenses in Patients with Laparoscopic Sleeve Gastrectomy

“…Therefore, obese patients should be closely followed up to check for obesity-related comorbidities and undergo bariatric surgery as soon as possible in cases where conservative or other treatments are ineffective in controlling weight. In addition to the factors explored above, a prospective cohort study pointed out that the rise of accelerated rehabilitation surgery (ERAS) in recent years has effectively alleviated the postoperative pain, nausea, or vomiting of patients undergoing bariatric surgery and signi cantly reduced the length of hospital stay, saving an average of $1458.62(10564.96 RMB Yuan) per person, reaching 21.25% of the total cost [21] . Thus, ERAS may serve as another key factor in further optimizing the hospital expenses of LSG patients.…”

O impacto de programas de reabilitação da marcha no tempo de internamento hospitalar – Scoping Review

“…Nas hepatectomias, numa pesquisa envolvendo 3739 participantes, o tempo de internamento foi reduzido em 2,22 dias no grupo ERAS e os custos hospitalares foram significativamente menores, em comparação com o grupo de tratamento padrão (p < 0,0001) (51). Em cirurgia bariátrica o tempo de internamento e os custos foram significativamente menores com a abordagem ERAS, implicando uma economia média de 21,25% do custo total do procedimento (52) .…”

Prehabilitation: The underutilised weapon for chronic pain management

“…Prehabilitative strategies are highly cost effective; pre-operative ERAS protocols indicate a mean saving of $1458.62 per patient, 21.5% of the total cost of surgical procedures from reduced subsequent healthcare utilisation. 21 Psychological intervention is utilised as a chronic pain management strategy (at point of treatment) due to its efficacy and cost effectiveness. 22 Thus, on an economic level, exploring psychological prehabilitation for chronic pain self-management is valuable to further enhance the cost benefits of pre-intervention protocols.…”