Abstract：
OBJECTIVE: Same day discharge (SDD) for colorectal surgery shows increasing promise in the era of enhanced recovery after surgery protocols and minimally invasive surgery. It has become increasingly relevant due to the constraints posed by the COVID-19 pandemic. The aim of this study was to compare SDD and postoperative day 1 (POD1) discharge to understand the clinical outcomes and financial impact on factors such as cost, charge, revenue, contribution margin and readmission.
METHODS: A retrospective review of colectomies was performed at a single institution over a 2-year period (n = 143). Two populations were identified: SDD (n = 51) and POD1 (n = 92). Patients were selected by International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) and Diagnosis Related Grouper (DRG) codes.
RESULTS: There was a statistically significant difference favouring SDD in total hospital cost (p < 0.0001), average direct costs (p < 0.0001) and average charges (p < 0.0016). SDD average hospital costs were $8699 (values in USD throughout) compared with $11 652 for POD 1 (p < 0.0001), and average SDD hospital charges were $85 506 compared with $97 008 for POD1 (p < 0.0016). The net revenue for SDD was $22 319 while for POD1 it was $26 173 (p = 0.14). Upon comparison of contribution margins (SDD $13 620 vs. POD1 $14 522), the difference was not statistically significant (p = 0.73). There were no identified statistically significant differences in operating room time, robotic console time, readmission rates or surgical complications.
CONCLUSIONS: Amidst the pandemic-related constraints, we found that SDD was associated with lower hospital costs and comparable contribution margins compared with POD1. Additionally, the study was unable to identify any significant difference between operating time, readmissions, and surgical complications when performing SDD.
METHODS: A retrospective review of colectomies was performed at a single institution over a 2-year period (n = 143). Two populations were identified: SDD (n = 51) and POD1 (n = 92). Patients were selected by International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) and Diagnosis Related Grouper (DRG) codes.
RESULTS: There was a statistically significant difference favouring SDD in total hospital cost (p < 0.0001), average direct costs (p < 0.0001) and average charges (p < 0.0016). SDD average hospital costs were $8699 (values in USD throughout) compared with $11 652 for POD 1 (p < 0.0001), and average SDD hospital charges were $85 506 compared with $97 008 for POD1 (p < 0.0016). The net revenue for SDD was $22 319 while for POD1 it was $26 173 (p = 0.14). Upon comparison of contribution margins (SDD $13 620 vs. POD1 $14 522), the difference was not statistically significant (p = 0.73). There were no identified statistically significant differences in operating room time, robotic console time, readmission rates or surgical complications.
CONCLUSIONS: Amidst the pandemic-related constraints, we found that SDD was associated with lower hospital costs and comparable contribution margins compared with POD1. Additionally, the study was unable to identify any significant difference between operating time, readmissions, and surgical complications when performing SDD.
摘要：
目的：结直肠手术当天出院（SDD）在手术方案和微创手术后增强恢复的时代显示出越来越多的希望。由于COVID-19大流行带来的制约，它变得越来越重要。这项研究的目的是比较SDD和术后第1天（POD1）出院，以了解临床结果以及对成本等因素的财务影响。charge,收入，缴费利润率和重新接纳。
方法：在2年的时间内，对单一机构的结肠切除术进行了回顾性回顾（n=143）。确定了两个群体:SDD(n=51)和POD1(n=92)。根据国际疾病和相关健康问题统计分类-10（ICD-10）和诊断相关石斑鱼（DRG）代码选择患者。
结果：在医院总费用中，有统计学意义的差异有利于SDD（p<0.0001），平均直接成本(p<0.0001)和平均费用(p<0.0016)。SDD的平均住院费用为8699美元（整个期间的价值以美元为单位），而POD1的平均住院费用为11652美元（p<0.0001），SDD的平均住院费用为85506美元，而POD1为97008美元(p<0.0016)。SDD的净收入为22319美元，而POD1的净收入为26173美元（p=0.14）。根据贡献利润率的比较(SDD$13620与POD1$14522),差异无统计学意义(p=0.73)。在手术室时间上没有发现统计学上的显著差异，机器人控制台时间，再入院率或手术并发症。
结论：在与大流行相关的限制中，我们发现,与POD1相比,SDD与较低的住院费用和可比的缴费利润率相关.此外,该研究无法确定手术时间之间的任何显着差异，再入院,以及执行SDD时的手术并发症。
方法：在2年的时间内，对单一机构的结肠切除术进行了回顾性回顾（n=143）。确定了两个群体:SDD(n=51)和POD1(n=92)。根据国际疾病和相关健康问题统计分类-10（ICD-10）和诊断相关石斑鱼（DRG）代码选择患者。
结果：在医院总费用中，有统计学意义的差异有利于SDD（p<0.0001），平均直接成本(p<0.0001)和平均费用(p<0.0016)。SDD的平均住院费用为8699美元（整个期间的价值以美元为单位），而POD1的平均住院费用为11652美元（p<0.0001），SDD的平均住院费用为85506美元，而POD1为97008美元(p<0.0016)。SDD的净收入为22319美元，而POD1的净收入为26173美元（p=0.14）。根据贡献利润率的比较(SDD$13620与POD1$14522),差异无统计学意义(p=0.73)。在手术室时间上没有发现统计学上的显著差异，机器人控制台时间，再入院率或手术并发症。
结论：在与大流行相关的限制中，我们发现,与POD1相比,SDD与较低的住院费用和可比的缴费利润率相关.此外,该研究无法确定手术时间之间的任何显着差异，再入院,以及执行SDD时的手术并发症。
