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. 2025 Apr 3;14(7):2460.
doi: 10.3390/jcm14072460.

Prehabilitation in Major Surgery: An Evaluation of Cost Savings in a Tertiary Hospital

Natalia Mudarra-García  1   2 , Fernando Roque-Rojas  3   4 , Visitación Izquierdo-Izquierdo  3 , Francisco Javier García-Sánchez  3   4
Affiliations

Prehabilitation in Major Surgery: An Evaluation of Cost Savings in a Tertiary Hospital

Natalia Mudarra-García et al. J Clin Med. .

Abstract

(1) Background: Prehabilitation programs improve patients' functional capacity before surgery by enhancing physical activity, nutrition, and psychological well-being, thereby reducing postoperative complications, hospital stays, and readmissions. We propose a centralized model led by an advanced practice nurse and internist to minimize consultations and reduce costs. (2) Methods: We studied 211 patients in a tertiary hospital in Madrid, with 135 enrolled in the centralized prehabilitation program and 76 in standard care (control). We compared complications, hospital stays, blood transfusions, and consultations, estimating costs using public pricing from Madrid's healthcare authorities. (3) Results: The centralized model significantly reduced blood transfusions (p = 0.014), postoperative complications (p < 0.001), and hospital stays (p = 0.004), leading to annual savings of EUR 593,453.00. (4) Conclusions: A centralized surgical prehabilitation model decreases complications, hospital stays, readmissions, and consultations compared to standard care, significantly reducing healthcare costs.

Keywords: advanced practice nurse; perioperative care; postoperative complications; prehabilitation; surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Prehabilitation process.
Figure 2
Figure 2
Ten phases of prehabilitation program.
Figure 3
Figure 3
Recruitment and selection diagram.
Figure 4
Figure 4
Total saving of the surgical prehabilitation program.
Figure 5
Figure 5
Distribution of total savings from a prehabilitation program.
Figure 6
Figure 6
Perioperative intervention.
See this image and copyright information in PMC

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