Comprehensive economic evaluation of enhanced recovery after surgery in hepatectomy

International Journal for Equity in Health

Chengcheng Jin¹  Yan Zhang²  Yihan Dong² 

[1] School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Qiaokou District, 430030, Wuhan, Hubei, China;Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030, Wuhan, China;School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Qiaokou District, 430030, Wuhan, Hubei, China;Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, 430030, Wuhan, China;

关键词: Enhanced recovery after surgery;    Hepatectomy;    Economic evaluation;    Social benefit;    Multiple perspective;   

DOI  :  10.1186/s12939-021-01583-3

来源: Springer

【 摘 要 】

BackgroundEnhanced recovery after surgery (ERAS) is attracting extensive attention and being widely applied to reduce postoperative stress and accelerate recovery. However, the economic benefits of ERAS are less clarified at the social level. We aimed to assess the economic impact of ERAS in hepatectomy from the perspectives of patients, hospitals and society, as well as identify the approach to create the economic benefits of ERAS.MethodsBy combining the literature and national statistical data, the cost-effectiveness framework was clarified, and parameter values were determined. Cost-effectiveness analysis, cost–benefit analysis and cost-minimisation analysis were used to compare ERAS and conventional treatment from the perspectives of patients, hospitals and society. The capital flow diagram was used to analyse the change between them.ResultsERAS significantly reduced the economic burden of disease on patients ($8935.02 vs $10,470.02). The hospital received an incremental benefit in ERAS (the incremental benefit cost ratio value is 1.09), and the total social cost was reduced ($5958.67 vs $6725.80). Capital flow diagram analysis demonstrated that the average daily cost per capita in the ERAS group increased ($669.51 vs $589.98), whereas the benefits depended on the reduction of hospital stay and productivity loss.ConclusionThe mechanism by which ERAS works is to reduce the average length of stay, thereby reducing the economic burden and productivity loss on patients and promoting the hospital bed turnover rate. Therefore, ERAS should further focus on accelerating the rehabilitation process, and more economic support (such as subsidies) should be given to hospitals to carry out ERAS.

【 授权许可】

CC BY