A. D. Ardeljan1, D. Manjani1, D. Maurente1,6, S. Willis1,7, H. S. Abdul1,5, A. Johns1,4, S. Sennhauser1, M. Ghali1, A. M. Rashid1,2, M. Perez1,3, O. M. Rashid1,2 1Holy Cross Hospital, Michael And Dianne Bienes Comprehensive Cancer Center, Fort Lauderdale,Fort Lauderdale, FLORIDA, USA 2Massachusetts General Hospital, Cancer Center, Boston,Boston, MASSACHUSETTS, USA 3University Of Miami Miller School Of Medicine, Miami,,Miami, FLORIDA, USA 4East Norriton Community Hospital, Philadelphia,Philadelphia, PENNSYLVANIA, USA 5Kendall Regional Medical Center,Kendall, FLORIDA, USA 6Eastern Virginia Medical School,Norfolk, VA, USA 7Saint Barnabas Hospital Health System,New York, NEW YORK, USA
Introduction: We have previously demonstrated that implementation of an enhanced recovery protocol (ERP) reduced Length of Stay (LOS) without any change in the readmission rate; however, the economic cost has not been quantified. The aim of this study was to evaluate the economic costs of ERP implementation at a community hospital.
Methods: Diagnostic Related Group (DRG) codes were used to assess costs associated with the hospitalizations of cases in the ERP versus non-ERP groups. The American Hospital Association (AHA) Annual Survey 1999-2015 was used to provide the expenses per day for inpatient hospitalization in the United States. Standard statistical methods were used.
Results: The AHA survey estimated the expenses of $2,265 incurred in a day for non-profit hospitals in Florida and $2,346 for the United States. For DRG 329, the reduction in LOS at a community hospital in ERP participating group reduced the cost of hospitalization from $27,297.96 (13.08 days) in the Non-ERP participating group to $7,033.19 (3.37 days); on average DRG 329, ERP reduced the cost by $20,264.77 per patient. For DRG 330, the reduction in LOS at a community hospital in ERP participating group reduced the cost of hospitalization from $22,664.82 (10.86 days) in the Non-ERP participating group to $ 9,558.46 (4.58 days); on average for DRG 330 ERP reduced the cost by $13,106.36 per patient. For DRG 331, the reduction in LOS at a community hospital in ERP participating group reduced the cost of hospitalization from $15,172.49 (7.27 days) in the Non-ERP participating group to $ 7,054.06 (3.38 days); on average for DRG 331, ERP reduced the cost by $8,118.43 per patient. LOS associated cost was compared between ERP and non-ERP groups: for DRG 329 the savings was $162,118.8 (n=12 non-ERP v n=8 ERP, p=4.39×10-18); for DRG 330, $314,552.64 (n=36 non-ERP v n=24 ERP, p=2.72×10-22); and for DRG 331, $89,302.73 (n=11 non-ERP v n=23 for ERP, p=4.19×10-20), respectively.
Conclusion: The implementation of ERP protocols significantly reduced the cost of hospitalization after bowel surgery based on the estimated expenses associated with LOS.