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Same day discharge colon surgery: is it financially worth it?
Karleigh R Curfman1, Gabrielle E Blair2, Callan L Kosnik1
1MultiCare Health Network, Tacoma, Washington, USA.
Summary
Same day discharge (SDD) for colorectal surgery significantly reduces hospital costs compared to postoperative day 1 (POD1) discharge. Clinical outcomes and contribution margins remain comparable between the two discharge strategies.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Healthcare Economics
Background:
- Enhanced recovery after surgery protocols and minimally invasive techniques have increased the feasibility of same day discharge (SDD) for colorectal surgery.
- The COVID-19 pandemic further highlighted the need for efficient hospital resource utilization, making SDD a relevant consideration.
Purpose of the Study:
- To compare clinical outcomes and financial impacts of same day discharge (SDD) versus postoperative day 1 (POD1) discharge for colorectal surgery.
- To analyze differences in cost, charge, revenue, and contribution margin between SDD and POD1 discharge groups.
Main Methods:
- A retrospective review of 143 colectomy patients over a 2-year period.
- Patients were divided into two groups: SDD (n=51) and POD1 discharge (n=92).
- Data was analyzed using International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) and Diagnosis Related Grouper (DRG) codes.
Main Results:
- SDD was associated with statistically significant lower total hospital costs ($8699 vs. $11,652) and average charges ($85,506 vs. $97,008) compared to POD1 discharge.
- No statistically significant differences were found in net revenue, contribution margin, operating room time, robotic console time, readmission rates, or surgical complications between the groups.
- SDD demonstrated a lower average hospital cost and charge, indicating potential financial benefits.
Conclusions:
- Same day discharge (SDD) for colorectal surgery is associated with reduced hospital costs and charges compared to postoperative day 1 (POD1) discharge.
- SDD offers comparable clinical outcomes, including readmission rates and surgical complications, to POD1 discharge.
- SDD presents a financially viable and clinically safe option for colorectal surgery patients, especially within pandemic-related constraints.
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