COST-EFFECTIVENESS OF THE USE OF ACERTO PROTOCOL IN MAJOR DIGESTIVE SURGERY

Area of Science:

• Surgical Oncology
• Gastroenterology
• Health Economics

Background:

• Hospital costs in surgery represent a significant global health system burden.
• Multimodal protocols, like the ACERTO project, aim to improve postoperative recovery.
• Perioperative care strategies are crucial for optimizing surgical outcomes and resource utilization.

Purpose of the Study:

• To analyze and compare hospital costs for major digestive surgical procedures.
• To evaluate the impact of the ACERTO project's perioperative care strategies on costs.
• To assess secondary outcomes including length of stay, complications, and mortality.

Main Methods:

• Retrospective analysis of elective major digestive surgery patients from 2002-2011.
• Comparison of pre-ACERTO (2002-2005) and ACERTO (2006-2011) implementation periods.
• Primary outcome: hospital costs; Secondary outcomes: length of stay, postoperative complications, surgical-site infection (SSI) rates, and mortality.

Main Results:

• The ACERTO period showed a median 3-day shorter length of stay (p=0.001).
• Postoperative complication risk was 29% higher and SSI risk was 33% higher in the pre-ACERTO period (p=0.002).
• Mean patient costs decreased from R$24,562.84 (pre-ACERTO) to R$19,912.81 (ACERTO) (p=0.02).

Conclusions:

• The ACERTO project implementation successfully reduced hospital costs for major digestive procedures.
• This perioperative care strategy also led to decreased length of stay and fewer postoperative complications and SSIs.
• The ACERTO project demonstrates the effectiveness of modern perioperative care in enhancing surgical recovery and reducing healthcare expenditure.