Financial Effect of Enhanced Recovery After Surgery in Autologous Breast Reconstruction.

IF 1.6 4区医学 Q3 SURGERY

Annals of Plastic Surgery Pub Date : 2025-06-01 DOI:10.1097/SAP.0000000000004391

Robert G DeVito, Benjamin G Ke, Kristen Stephens, Scott T Hollenbeck, Chris A Campbell, John T Stranix

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引用次数: 0

Abstract

Background: Enhanced Recovery After Surgery (ERAS) pathways have become increasingly common in surgery, but the ERAS financial impact on autologous breast reconstruction has not been defined.

Methods: This study performed a retrospective review of consecutive autologous breast reconstructions (July 2017 to June 2022; 264 patients, 156 pre-ERAS implementation and 108 post-ERAS implementation). Clinical outcomes included length of stay (LOS), ICU length of stay (ICU LOS), average daily morphine milligram equivalent (MME) use, and average total MME use. Financial metrics evaluated the total charges, total cost, direct cost, indirect cost, estimated reimbursement, and direct margin.

Results: Average LOS was lower in the ERAS cohort (2.13 vs. 3.21 days, P < 0.001). Average ICU LOS was lower in the ERAS cohort (0.0 vs 0.75 days, P < 0.001). Total charges were lower in the ERAS cohort ($98,876 vs. $119,568, P < 0.001). Total cost was lower in the ERAS cohort ($25,725 vs. $30,972, P < 0.001). Direct cost was lower in the ERAS cohort ($15,900 vs. $18,823, P < 0.001). Indirect cost was lower in the ERAS cohort ($9825 vs. $12,149, P < 0.001). Estimated reimbursement was equivalent ($27,464 vs. $24,697, P = 0.14). Direct margin was higher in the ERAS cohort ($11,564 vs. $5874, P = 0.0015).

Conclusions: ERAS pathways in autologous breast reconstruction decrease length of stay, ICU utilization, and improve financial metrics. Further investigations into quality improvements in ERAS warrant investigation.

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自体乳房再造术提高术后恢复的经济效益。

背景：手术后增强恢复（ERAS）途径在外科手术中越来越普遍，但ERAS对自体乳房重建的经济影响尚未明确。方法：本研究对2017年7月至2022年6月连续自体乳房重建进行回顾性分析；264例患者（eras术前156例，eras后108例）。临床结果包括住院时间（LOS）、ICU住院时间（ICU LOS）、平均每日吗啡毫克当量（MME）使用量和平均总MME使用量。财务指标评估总费用、总成本、直接成本、间接成本、估计报销和直接利润。结果：ERAS组的平均LOS较低（2.13天和3.21天，P < 0.001）。ERAS组ICU平均LOS较低（0.0 vs 0.75天，P < 0.001）。ERAS组的总费用较低（98,876美元对119,568美元，P < 0.001）。ERAS组的总成本较低（25,725美元对30,972美元，P < 0.001）。ERAS组的直接成本较低（15900美元vs 18823美元，P < 0.001）。ERAS组的间接成本较低（9825美元vs 12149美元，P < 0.001）。估计报销金额相等（27,464美元对24,697美元，P = 0.14）。ERAS组的直接利润率更高（11,564美元对5874美元，P = 0.0015）。结论：ERAS途径在自体乳房重建术中减少了住院时间、ICU使用率，并改善了财务指标。进一步调查的质量改进的ERAS值得调查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Plastic Surgery 医学-外科

CiteScore

2.70

自引率

13.30%

发文量

584

审稿时长

6 months

期刊介绍： The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.