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Background: An Acute Pain Service (APS) has been shown to improve patient outcomes and decrease complications by achieving adequate pain control and decreasing opioid use. However, it is less obvious if having a dedicated APS postoperatively directly translates to patient-centered or hospital cost benefits. This study aimed to determine if there was a cost benefit between a matched cohort of patients with and without a dedicated APS after a planned ventral wall hernia repair. Methods: A historical cohort study was conducted. After 1:1 matching, 40 patients were included for analysis. The non-APS group received a thoracic epidural postoperatively managed by the anesthesiology department. The APS group received various continuous peripheral nerve blocks and analgesia exclusively managed by a dedicated APS. Data was recorded for each group regarding surgical techniques, postoperative complications, opioid use and induced side effects, hospital length of stay, and resource utilization for both groups. Results: Compared to the non-APS group, adjusted opioid consumption per day was almost half in the APS group (P= 0.0067). The average hospital length of stay was 3.4 days less (P= 0.0401) , and there was a statistically significant reduction in several recovery milestones that likely contributed to a timely discharge in the APS group. After factoring costs of APS utilization, the APS was shown to save an average of $5,440.59 of total cost per patient. Discussion: The addition of a dedicated postoperative APS significantly reduced opioid consumption and improved outcomes of patients and resulted in reduced healthcare costs. |
