A reduction in hospital length of stay reduces costs for colorectal surgery: an economic evaluation of the National Surgical Quality Improvement Program in Singapore.

Autor: Tan EJKW; Department of Colorectal Surgery, Singapore General Hospital, Academia, 20 College Road, Singapore, 169856, Singapore. emilekwtan@gmail.com., Chen HLR; Department of Colorectal Surgery, Singapore General Hospital, Academia, 20 College Road, Singapore, 169856, Singapore., Chok AY; Department of Colorectal Surgery, Singapore General Hospital, Academia, 20 College Road, Singapore, 169856, Singapore., Tan IE; Group Finance Analytics, Singapore Health Services, Singapore, 168582, Singapore., Zhao Y; Department of Colorectal Surgery, Singapore General Hospital, Academia, 20 College Road, Singapore, 169856, Singapore.; Group Finance Analytics, Singapore Health Services, Singapore, 168582, Singapore., Lee RS; Group Finance Analytics, Singapore Health Services, Singapore, 168582, Singapore., Ang KA; Finance, Singapore General Hospital, Singapore, 169608, Singapore., Au MKH; Group Finance Analytics, Singapore Health Services, Singapore, 168582, Singapore.; Finance, Singhealth Community Hospitals, Singapore, 168582, Singapore., Ong HS; Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, 169608, Singapore., Ho HSS; Department of Urology, Singapore General Hospital, Singapore, 169608, Singapore., Poopalalingam R; Department of Anesthesiology, Singapore General Hospital, Singapore, 169608, Singapore., Tan HK; Singapore General Hospital, Singapore, 169608, Singapore.; SingHealth Duke-NUS Global Health Institute, Singapore, Singapore., Kwek KYC; Singapore General Hospital, Singapore, 169608, Singapore.; Singapore Health Services, Singapore, 168582, Singapore.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2023 Oct 26; Vol. 38 (1), pp. 257. Date of Electronic Publication: 2023 Oct 26.
DOI: 10.1007/s00384-023-04551-1
Abstrakt: Purpose: In 2017, the National Surgical Quality Improvement Program (NSQIP) was introduced in the Department of Colorectal Surgery at Singapore General Hospital as a pilot quality improvement initiative. This study aimed to examine the cost-effectiveness of NSQIP by evaluating its effects on surgical outcomes, length of stay (LOS), and costs.
Methods: We retrospectively reviewed patients undergoing colorectal surgery (2017-2020). Patients were divided into two cohorts: pre-NSQIP (2017-2018) and post-NSQIP (2019-2020). Outcomes evaluated were 30-day postoperative complications, LOS, and costs. Total cost-savings from NSQIP intervention's impact on LOS were estimated using a decision model with a one-way sensitivity analysis. Multivariate logistic regression was performed to identify factors for prolonged LOS.
Results: 1905 patients underwent colorectal surgery, with 996 in the pre-NSQIP cohort and 909 in the post-NSQIP cohort. A significant reduction in overall postoperative complications of 4.7% was observed in the post-NSQIP cohort (36.5% vs. 31.8%, p = 0.029). Patients in the post-NSQIP cohort had a shorter median LOS (8.0 vs. 6.0 days, p < 0.001). The implementation of NSQIP resulted in an 8.5% decrease in prolonged LOS > 6 days (p < 0.001), saving S$0.31 million on LOS. Total costs per case were reduced by 20.8% following NSQIP (S$39,539.05 vs. S$31,311.93, p < 0.001).
Conclusion: Implementing NSQIP has significantly reduced overall postoperative complications, LOS, and costs and achieved cost savings following colorectal surgery.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: