Cheng Stephanie, Lee Phong Ching, Sim Jacqueline X L, Tan Ai Shan, Ng Cindy L W, Foo Angelina X Y, Abdullah Hairil Rizal Bin, Tan Jeremy T H, Ong Hock Soo, Lim Chin Hong
Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Level 5; Academia, 20 College Road, Singapore, 169856, Singapore.
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Surg Endosc. 2023 Nov;37(11):8349-8356. doi: 10.1007/s00464-023-10414-1. Epub 2023 Sep 12.
We aim to evaluate the cost-saving of the short stay ward (SSW) versus conventional inpatient care following sleeve gastrectomy (LSG). We also compared the readmission rates pre- and post-inception of the intravenous hydration clinic and analyzed the cost-savings.
Patients who underwent LSG between December 2021 to March 2022 with SSW care were compared with standard inpatient care. Total costs were analyzed using univariate analysis. With a separate cohort of patients, 30-day readmission rates in the 12-months preceding and following implementation of the IV hydration clinic and associated cost-savings were evaluated.
After matching on the propensity score to within ± 0.1, 20-subjects pairs were retained. The total cost per SSW-subject was significantly lower at $13,647.81 compared to $15,565.27 for conventional inpatient care (p = 0.0302). Lower average ward charges ($667.76 vs $1371.34, p < 0.0001), lower average daily treatment fee per case ($235.68 vs $836.54, p < 0.0001), and lower average laboratory investigation fee ($612.31 vs $797.21, p < 0.0001) accounted for the difference in costs between the groups. Thirty-day readmission rate reduced from 8.9 to 1.8% after implementation of the hydration clinic (p < 0.01) with decreased 30-day readmission cost (S$96,955.57 vs. S$5910.27, p < 0.01).
SSW for LSG is cost-effective and should be preferred to inpatient management. Walk-in hydration clinics significantly reduced readmission rates and result in tremendous cost-savings.
我们旨在评估袖状胃切除术（LSG）后短期住院病房（SSW）相较于传统住院治疗的成本节约情况。我们还比较了静脉补液诊所设立前后的再入院率，并分析了成本节约情况。
将2021年12月至2022年3月期间接受LSG并采用SSW护理的患者与标准住院护理患者进行比较。使用单因素分析来分析总成本。对于另一组患者，评估了静脉补液诊所实施前后12个月内的30天再入院率及相关成本节约情况。
在倾向得分匹配至±0.1以内后，保留了20对受试者。每个SSW受试者的总成本显著低于传统住院护理的15,565.27美元，为13,647.81美元（p = 0.0302）。较低的平均病房费用（667.76美元对1371.34美元，p < 0.0001）、较低的每例平均每日治疗费（235.68美元对836.54美元，p < 0.0001）以及较低的平均实验室检查费（612.31美元对797.21美元，p < 0.0001）导致了两组之间的成本差异。补液诊所实施后，30天再入院率从8.9%降至1.8%（p < 0.01），30天再入院成本降低（96,955.57新元对5910.27新元，p < 0.01）。
LSG采用SSW具有成本效益，应优先于住院管理。无需预约的补液诊所显著降低了再入院率，并带来了巨大的成本节约。
