The Financial Impact of Colorectal Enhanced Recovery After Surgery: A Single-Centre Retrospective Pre-Post...

Area of Science:

• Colorectal Surgery
• Healthcare Economics
• Perioperative Care

Background:

• Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care in colorectal surgery, improving patient outcomes and reducing hospital stays.
• Despite evidence of cost benefits, ERAS is not yet standard practice in Australia, lacking local economic data.
• This study aims to compare healthcare system costs for elective colorectal resections using ERAS versus conventional care in Australia.

Purpose of the Study:

• To retrospectively compare the total healthcare system costs for elective colorectal resections performed with ERAS compared to conventional perioperative management.
• To evaluate the economic impact of ERAS implementation in an Australian public hospital setting.
• To assess the relationship between ERAS, patient outcomes, and associated healthcare costs.

Main Methods:

• A single-centre, retrospective cohort study compared costs between ERAS and conventional care (CC) for elective colorectal resections.
• Costs were manually calculated, encompassing pre-admission, operative, postoperative, and readmission phases from 2010 to 2022.
• Patient outcomes were cross-examined with cost data to understand the impact of care variations.

Main Results:

• The study included 642 patients; 405 underwent ERAS and 237 received CC.
• ERAS implementation led to a statistically significant median cost reduction of 2010 AUD per patient (p=0.008).
• ERAS was associated with a reduced median length of stay (5 vs. 6 days, p<0.001) and a lower overall complication rate (26.42% vs. 37.55%, p=0.003).

Conclusions:

• Colorectal ERAS significantly reduces per-patient costs for elective resections in Australian public hospitals.
• Cost savings are primarily driven by reduced length of stay and improved complication rates, particularly for Grades I-II complications.
• A year-on-year downward cost trend was observed as the ERAS program matured, indicating potential for sustained future economic benefits.