EP351 - Costs in colorectal surgery with the ERAS protocol in low- to middle-income countries: a health benefit cost study.

Sunday, May 11, 2025

8:21 AM – 8:26 AM PT

Location: Monitor 9, Sails Pavilion, Upper Level

ePoster Presenter(s)

JC

Jessica Capre-Pereira, MD

Colorectal surgeon
Fundacion Valle del Lili, Cali, Colombia. Universidad ICESI, Cali, Colombia.
Cali, Valle del Cauca, Colombia

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

HP

Helber F. Perez, MD

Research Assistant
Centro de Investigaciones Clínicas, Fundacion Valle del Lili, Cali, Colombia. Universidad ICESI, Master's student in Epidemiology Universidad Libre, Chapter of Future Surgeons, Colombian Association of Surgery.
CALI, Valle del Cauca, Colombia

Disclosure information not submitted.
AG

Andres Gempeler, MD MSc

Magister in Epidemiology, Methodological Analyst
Centro de Investigaciones Clínicas, Fundación Valle del Lili,
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
JH

Juan-Guillermo Holguin, MD

Colorectal surgeon
Fundacion Valle del Lili, Cali, Colombia. Universidad ICESI, Cali, Colombia.
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
AO

Alexander Obando, MD

Colorectal surgeon
Fundacion Valle del Lili, Cali, Colombia. Universidad ICESI, Cali, Colombia.
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
EB

Einar Billefals, MD

Anesthesiologist, Chief of General Operating Rooms
Fundacion Valle del Lili, Cali, Colombia
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
MB

Monica Bejarano, MD MSc

Surgeon General, Editor of the Colombian Journal of Surgery
Fundacion Valle del Lili, Cali, Colombia
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
YC

Yaset Caicedo, MD

Surgery Resident
Facultad de Ciencias de la Salud, Universidad ICESI
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
LH

Lina Hincapie, MSc

Operational Coordinator of Agreements
Fundacion Valle del Lili, Cali, Colombia
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.
SP

Sergio Ivan Prada, MSc MBA PhD

Deputy Director of Research and Innovation
Fundacion Valle del Lili, Cali, Colombia
Cali, Valle del Cauca, Colombia

Disclosure information not submitted.

Senior Author(s)

AK

Abraham Kestenberg, MD

Colorectal Surgeon, Director of the Department of Coloproctology and Academic Director of Fellow in
Fundacion Valle del Lili, Cali, Colombia. Profesor in Universidad ICESI, Cali, Colombia
Cali, Valle del Cauca, Colombia

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Jessica Capre-Pereira, MD: This individual has no financial relationships with ineligible companies.

Abraham Kestenberg, MD: This individual has no financial relationships with ineligible companies.

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Purpose/Background: The recommendations of the Enhanced Recovery After Surgery (ERAS) protocol around the world and in the national territory have demonstrated favorable clinical results. However, there is diverse evidence regarding its benefit in hospital care costs, and its economic impact has not been studied in Latin America. Therefore, the present study aims to analyze the impact of the ERAS protocol on hospital care costs in colorectal surgery between 2021 and 2024 in a high-complexity hospital.

Methods/Interventions: Cost analysis study of patients undergoing major colorectal surgery (lasting over 2 hours) with or without ERAS recommendations from 2021 to April 2024 in a high-complexity hospital in Colombia. Costs for intrahospital episodes, pre-surgical evaluations, complications, readmissions, and outpatient follow-up were collected. A price vector standardized care costs across different years and health insurances. A comparison of costs and outcomes between the two groups was conducted. The prices associated with healthcare services are presented in Colombian pesos (COP) and U.S. dollars (USD), with the exchange rate as of today (1 U.S. dollar = 3,952.14 COP). The obtained prices were compared using a t-test due to their distribution. A p-value of less than 0.05 was considered statistically significant, and categorical variables were analyzed using a chi-square test.

Results/Outcomes: A total of 173 patients were included, of which 84 were ERAS patients and 89 were non-ERAS patients. In both groups, there was a higher proportion of adults and older adults, and the vast majority were men. The average care cost for ERAS patients was $49,587,838 COP ($12,552 USD), while for non-ERAS patients it was $74,250,099 COP ($18,792 USD) (p < 0.001). Complications occurred in 7.14% (6/84) of ERAS patients, compared to 29.21% (26/89) of non-ERAS patients (p < 0.001). In terms of costs, complications in both groups had similar costs per patient (p = 0.41).

Conclusion/Discussion: The implementation of the ERAS protocol in middle- to low-income regions may generate not only favorable clinical outcomes but also a benefit in healthcare costs. In challenging contexts for maintaining healthcare systems, the ERAS protocol can be an alternative that allows for resource optimization.