强化恢复计划的坚持:哪些组件与成本节约有关?
Alfonsus Adrian H Harsono1, Lauren Wood1, Gianina C Hernandez-Marquez1
1University of Alabama at Birmingham, Department of Surgery, Birmingham, Alabama.
Journal of the American College of Surgeons
|February 26, 2026
概括
增强恢复计划 (ERP) 显著降低了成本,特别是通过避免鼻胃管和早期患者动员来降低成本. 专注于这些关键ERP组件可以优化手术护理的成本节约.
科学领域:
- 手术护理途径 手术护理途径
- 卫生经济学 卫生经济学
- 基于证据的医学基于证据的医学.
背景情况:
- 增强恢复计划 (ERP) 是基于证据的手术护理协议.
- 虽然ERP提高了结果并降低了成本,但驱动成本节约的具体组件尚未明确定义.
- 识别节省成本的ERP组件可以改进实施策略.
研究的目的:
- 确定增强恢复计划 (ERP) 的哪些组成部分与显著的成本节约有关.
- 为ERP的未来实施策略提供指导.
主要方法:
- 一个回顾性队列研究334个结直肠外科手术患者接受ERP从2021-2023.
- 1:1的倾向匹配分析比较了16个ERP组件的高 (≥70%) 和低 (<70%) 坚持.
- 从机构ERP,财务和医疗记录中分析的数据.
主要成果:
- 高ERP坚持患者的总成本较低 (17,576美元与22,343美元).
- 节省成本的组件包括:没有鼻胃管 (NGT),早期动员,早期饮食,维护静脉注射液 (IVF) 停止,以及早期的福利切除.
- 没有NGT,早期动员和维护试管婴儿的停用始终降低了各个坚持水平的成本.
结论:
- 坚持特定的增强恢复计划 (ERP) 组件与成本节省直接相关.
- 针对性干预侧重于高影响因素,如避免NGT和促进早期动员,对于最大限度地降低成本至关重要.
- 达到70%的整体遵守率和优先考虑关键组件可以提高ERP的财务效益.
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