Cost-effectiveness of the enhanced recovery program in patients undergoing colon surgery. Results of randomized clinical trial

Abstract

AIM: to evaluate the cost-effectiveness of the enhanced recovery program (ERP).PATIENTS AND METHODS: a randomized clinical trial was carried out. A total of 152 patients were divided into ERP (n = 77) and conventional (n = 75) groups. To study the cost-effectiveness of ERP, direct medical costs were assessed at all stages of treatment (outpatient, inpatient, and also within 30 days after discharge from the hospital). Cost minimization analysis (CMA) was used.RESULTS: the median total costs at the stage of outpatient check-up ERP and conventional groups where comparable (33115-35146 rubles; p = 0.1). The total cost of inpatient treatment in the main group was 175,535 rubles, in the control group — 199,055 rubles (p < 0.0001). The costs of outpatient follow-up in ERP group were significantly higher compared to the conventional group (p = 0.0005). The difference, according to Hodges-Lehmann estimation, was 940.7 rubles. The cost of the entire cycle of treatment in the ERP group was 214805 rubles, in the conventional — 237890 rubles (p < 0.0001). Thus, the total reduction in treatment costs associated with ERP amounted to 23,085 rubles (9.7% expenditures)CONCLUSION: a cost-effectiveness analysis of the implementation of the Enhanced Recovery Program showed an overall cost reduction of 9.7% due to a reduction in costs at the inpatient stage.