M. J. Holmes1, M. J. McCarroll1, R. J. Berkowitz1, J. S. Lee1, L. E. Junge1, B. C. Kenney1, S. C. Wang1, R. S. Sung1, M. J. Englesbe1, K. J. Woodside1 1University Of Michigan,Ann Arbor, MI, USA
Introduction: The Michigan Surgical & Health Optimization Program (MSHOP) is an economically cost efficient program that ‘trains’ patients for surgery. MSHOP is designed to help patients make incremental adjustments in their daily routine that can have a large effect on their recovery following surgery. The program focuses on increasing physical activity via a pedometer, breathing exercise to improve lung function using an incentive spirometer and helping smokers make a plan to quit, developing a balanced diet plan, and managing emotional and psychological stressors by practicing in relaxation techniques. We examined the impact of the program on living donor kidney recipients’ length of stay, hospital readmission within 90 days, postoperative complications, and charges and expected payment.
Methods: Retrospective clinical, program participation, demographic, and financial data from 106 living donor kidney transplant recipients enrolled in MSHOP between June 2015 and July 2017 were obtained. Patients that recorded steps at a minimum of 3 times per week for the majority of weeks enrolled were defined as adherent to the program. Categorical variables were compared using Fisher’s exact test. Continuous variables were compared using Student's t-test and the Mann-Whitney U test. Primary measures are, length of stay, hospital readmission within 90 days, postoperative complications, and charges and expected payment.
Results: Of the total 106 patients, 83 were enrolled in MSHOP, and 23 were not. Of the 83 enrolled, 66 were compliant and 17 were not compliant. MSHOP compliant patients had a trend towards decreased rate of readmission within 90 days, postoperative complications, and charges with expected payment (Table).
Conclusion: While strong conclusions are limited by modest sample size, we found an intriguing emerging trend towards potential hospital cost saving implications associated with patient participation in MSHOP. It is possible that this trend is the result of decreased postoperative complications hospital readmissions.
