National trends and costs of same day discharge in patients undergoing elective minimally invasive colectomy.

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-10-16 DOI:10.1016/j.amjsurg.2024.116021

Wardah Rafaqat, Mahin Janjua, Omar Mahmud, Bradford James, Baryalay Khan, Hanjo Lee, Aimal Khan

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引用次数: 0

Abstract

Background: Enhanced Recovery Pathways (ERPs) have enabled safe same day discharge (SDD) of select patients after elective minimally invasive colectomy. We aimed to analyse the financial impact of SDD in these cases.

Methods: We queried the Nationwide Readmission Database (2016-2019) and included patients with a hospital length of stay ≤2 days after minimally invasive elective colectomy. Propensity score matched pairs of patients discharged on the day of the operation and those discharged on post operative day 1 or 2 were compared. Our primary outcome was the combined cost of hospitalization and readmission.

Results: SDD patients had lower comorbidity (33 % vs 21 %) and illness severity (79 % vs 63 %), more Medicare insurance (44 % vs 38 %), and more benign neoplasms (52 % vs 17 %). Most SDD patients underwent right colectomy (89 %). Across 647 matched pairs, total cost was significantly lower in SDD patients ($8000 vs. $12,900; p < 0.001) due to cheaper index hospitalizations. No difference in readmission rates or costs emerged.

Conclusion: SDD reduced costs of index hospitalization and may be cost-effective in a select cohort of healthier patients.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.