Significant projected savings with expansion of an emergency department observation protocol for mild acute
Nikhil Thiruvengadam1, Kelsey L Anderson2, Sunil G Sheth2
1Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, CA, USA.
Background:
Acute pancreatitis (AP) significantly contributes to healthcare costs, but not all patients require hospitalization. A novel, validated Emergency Department (ED) pathway for mild AP (MAP) at our tertiary care center reduced hospitalizations and resource utilization, without affecting outcomes.
Methods:
A decision-analytic model was constructed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and methodologic recommendations by the Second Panel on Cost-Effectiveness in Health and Medicine to predict healthcare costs based on whether an ED discharge protocol for MAP was utilized.
Results:
Average savings for one MAP discharged from the ED were $1720.5 compared to the standard of care hospitalization. Assuming that 67.7 % of cases are mild and that there are 288,820 hospitalizations for AP annually, the ED discharge pathway would result in $98.6 million direct healthcare savings.
Conclusions:
Implementation of an evidence-based, protocoled ED pathway for MAP could result in over $100 million in direct healthcare savings.
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