ArticleActa medica Philippina2025
Cost Analysis of Enhanced Recovery After Surgery (ERAS) in Elective Colorectal Surgery in a Philippine Government Hospital.
Article in Acta medica Philippina, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Division of Colorectal Surgery at the Philippine General Hospital (PGH) conducts hundreds of surgeries annually for benign and malignant colorectal conditions. Since 2019, the Division has implemented an Enhanced Recovery After Surgery (ERAS) program to improve patient outcomes. However, its impact on hospital costs-critical for a government hospital-has not yet been studied. Objective: This study aimed to evaluate the effect of ERAS on healthcare costs for elective colorectal surgeries performed at PGH in 2021. Methods: A retrospective observational study was conducted on adult patients who underwent elective colorectal surgeries under the ERAS protocol in 2021. Medical and billing records were retrieved using the hospital's electronic medical records (EMR) system, excluding cases with incomplete data. Procedures were categorized by type [stoma closure, colonic or rectal resection, reversal of Hartmann's, or cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)] and surgical approach (open, laparoscopic, or robotic). Costs were classified into diagnostics, facility fees, medications, surgery, and hospital supplies. ERAS compliance rates were extracted from the online ERAS Interactive Audit System (EIAS), and linear regression analysis was performed. Results: Among 114 elective colorectal surgeries, records for 90 cases were analyzed. Surgery-related expenses accounted for the highest mean hospital costs across all procedure types. An inverse correlation between ERAS compliance and total cost was observed for open surgeries, with statistically significant reductions in stoma closures and open colon resections ( Conclusion: Standardized care through ERAS has been associated with cost savings compared to traditional perioperative management. This study supports the conclusion that higher ERAS compliance can reduce hospital costs in open colorectal surgeries. However, the higher costs of MIS procedures, driven by equipment-related expenses, may offset potential savings from ERAS adherence. Further research is warranted to explore the cost implications of ERAS in MIS cases.
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