Health Economics Evaluation Research About Enhanced Recovery After Surgery For Clinical Surgery

Objective The patient’s understanding of the pathophysiology is gradually increasing during the perioperative period,and the zero-risk and no-pain requirements are also increasing for the entire perioperative treatment process with the advancement of society and the development of medical technology,especially the rapid advancement of surgical techniques.Enhanced recovery after surgery has emerged as the times required.ERAS was first proposed by Professor Kehlet of Denmark in 1997 and introduced to China in2007 by Academician Li Jieshou.It has gradually become popular,but it also faces many problems in the process of popularization with the development.We don’t know whether the clinical application of ERAS really brings benefits to patients.This article attempts to explore the clinical efficacy and economic benefits of ERAS after clinical surgery.Methods Most of the studies were analyzed from a clinical perspective,ignoring the important aspect of economic benefits.It mostly adopted normative research methods,and the conclusions often lack theoretical support and empirical tests.Therefore,we selected three types of patients undergoing radical gastrectomy for gastric cancer,partial hepatectomy for primary hepatocellular carcinoma,and radical resection for colorectal cancer as subjects to analyze changes in clinical efficacy(the opreation time,intraoperative blood loss,length of hospital stay,complication,readmission)and hospitalization costs resulting from ERAS.Results From the published articles and data,it can be known that ERAS has good clinical efficacy in clinical surgery at this stage,and there are differences in postoperative and perioperative outcomes and hospitalization costs for various types of clinical operations.There was no significant difference between the two groups of patients in terms of age,ASA grade,opreation sites and methods in three kinds of surgery,which was comparable.The length of hospital stay and the complication were significant different between the two groups(P<0.05).The hospitalization cost between the two groups was also significantly different(P<0.05).Cost-effectiveness analysis,incremental analysis and other economic evaluations were used to determine the economic benefits after the application of ERAS to patients.Conclusion and recommendation ERAS helps to shorten the hospitalization time,reduces complications and promotes the recovery of patients.ERAS played an important role in alleviating the economic burden of patients.The cost of radical gastrectomy reduce the most in three types of surgery.In general,ERAS has a good application prospect.Through input-output analysis,it can be found that ERAS will bring better economic and social benefits.Therefore,we should gradually improve the regulation of ERAS,integrating various effective measures,establishing targeted ERAS procedures,increasing the overall application level of clinical departments and promoting the actual clinical experience from the tertiary hospital to the next level hospital.