Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;31(4):1612-1617.
doi: 10.1007/s11695-020-05168-x. Epub 2021 Jan 19.

Impact of Enhanced Recovery After Bariatric Surgery (ERABS) Protocol in Reducing Length of Stay and Hospitalization Costs: the Experience of a Philanthropic Hospital in Brazil

Marcos Paulo Gouveia de Oliveira  1 , Gustavo Fernandes  2 , Juliana Fernandes Andrade  2 , Danilo Pereira Barbosa  3 , Pamela França Silva  4 , Ana Carolina Franceschilli Bossi  4 , Ana Beatriz Monteiro Correa da Costa E Silva  4
Affiliations

Impact of Enhanced Recovery After Bariatric Surgery (ERABS) Protocol in Reducing Length of Stay and Hospitalization Costs: the Experience of a Philanthropic Hospital in Brazil

Marcos Paulo Gouveia de Oliveira et al. Obes Surg. 2021 Apr.

Abstract

Overview: The global prevalence of obesity and increase in bariatric surgeries are burdening the healthcare system. Enhanced recovery postoperative protocols are associated with a reduction in hospitalization costs and length of stay (LOS) and may be an alternative to reduce public health expenses.

Objective: To assess the impact of implementing a customized Enhanced Recovery After Bariatric Surgery (ERABS) protocol on hospitalization costs (HC), LOS, and complication rates.

Setting: Santa Marcelina Hospital, São Paulo, Brazil.

Methods: A retrospective electronic health record analysis of patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and who were cared for within a clinical pathway (CP) protocol (Jan. 2016-Aug. 2018) or after implementation of an ERABS protocol (Aug. 2018-Jun. 2019). The LOS, HC, and complication, readmission, and reoperation rates were compared between the two groups.

Results: Eighty-two patients were included in the study (CP, 56, 87.5% women; ERABS, 26, 92.3% women). Hospital LOS and total HC decreased significantly by 32.5% and 15.2%, respectively (both, p < 0.05), after implementation of ERABS. There were no significant differences in 30-day readmission, complication, or reoperation rates.

Conclusion: The implementation of a standardized enhanced recovery program resulted in reduced LOS and HC without an increase in perioperative morbidity. The ERABS protocol is cost-effective and can help ease the healthcare burden.

Keywords: Bariatric surgery; Clinical pathway; ERABS; ERAS; Fast-track; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. - DOI
    1. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metab Clin Exp. 2019;92:6–10. - DOI
    1. Childers DK, Allison DB. The ‘obesity paradox’: a parsimonious explanation for relations among obesity, mortality rate and aging? Int J Obes. 2010;34:1231–8. - DOI
    1. De Oliveira ML, Santos LMP, Silva EN. Direct healthcare cost of obesity in Brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011. PLOS ONE. 2015;10(4):e0121160. - DOI
    1. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61. - DOI

LinkOut - more resources