Enhanced recovery program; ERP implementation; Retrospective cohort study; Adult; Aged; Aged, 80 and over; Enhanced Recovery After Surgery; Female; France; Humans; Longitudinal Studies; Male; Middle Aged; Retrospective Studies; Young Adult; Medicine (all)
Abstract :
[en] Introduction: The aim of this study was to analyze the rate of enhanced recovery programs (ERP) implementation in a range of surgical specialties in both the public and private sectors. Methods: This was a retrospective longitudinal study based on hospital stays between March to December 2019. We studied thirteen of the activity segments most frequently included in ERP protocol. The procedures selected included digestive, gynecological, orthopedic, thoracic, and urological procedures. The assessment criteria was the rate of ERP. The results were analyzed first overall and then matching ERP stays to non-ERP stays according to type of institution, patient age and sex, month of discharge, and Charlson comorbidity score. Results: We took 420,031 stays into account, of which 78,119 were coded as ERP. There were 62,403 non-ERP stays. Depending on the type of surgery, the implementation rate ranged from 5 percent to 30 percent. The overall rate of ERP implementation was higher in the private sector (21.2 percent) than in the public sector (14.4 percent). The results are reversed for some surgeries, notably for some cancers. Patients had a higher Charlson score in the public sector. Conclusions: This large-scale national study provides a picture of the degree of diffusion of ERPs in France. Although there are differences between sectors, this diffusion is still insufficient overall. Given the demonstrated benefits of ERPs, more educational efforts are needed to improve their implementation in France.
Disciplines :
Surgery
Author, co-author :
Delaunay, Laurent; Département d’anesthésie réanimation, Clinique Générale, Annecy, France
Slim, Karem; Département de chirurgie digestive, Hôpital universitaire de Clermont-Ferrand, France
Briquet, Emmanuel; Directeur médical, Groupe Vivalto Santé, Paris, France
Joris, Jean ; Université de Liège - ULiège > Département des sciences de la santé publique
Boudemaghe, Thierry; Département informatique médicale, S.I.M.M.E.R., Hôpital universitaire de Nîmes, France
Leger, Lucas; Département l’information financière et d’audit, ESCP, Paris, France
Bizard, Frédéric; Département d’information financière et d’audit, École supérieure de Commerce de Paris, Paris, France
Language :
French
Title :
Diffusion de la réhabilitation améliorée après chirurgie en France. Étude nationale à grande échelle, à partir des données du PMSI
Alternative titles :
[en] The spread of enhanced recovery after surgery in France. A large-scale national study, based on data from the French hospital discharge database (PMSI)
Publication date :
2024
Journal title :
Santé Publique: Revue Multidisciplinaire pour la Recherche et l'Action
ISSN :
0995-3914
eISSN :
2104-3841
Publisher :
Société Française de Santé Publique, Vandœuvre-lès-Nancy, France
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