Abstract：
BACKGROUND: 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.
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.
摘要：
背景：这项研究的目的是分析在公共和私营部门的一系列外科专业中实施增强恢复计划（ERP）的比率。
方法：这是一项基于2019年3月至12月住院时间的回顾性纵向研究。我们研究了ERP协议中最常见的13个活动部分。选择的程序包括消化，妇科,骨科,胸廓,和泌尿外科手术。评估标准是ERP的比率。首先对结果进行总体分析，然后根据机构类型将ERP停留与非ERP停留相匹配，患者年龄和性别,出院月份，和Charlson合并症得分.
结果：我们考虑了420,031次停留，其中78119个被编码为ERP。有62,403个非ERP停留。根据手术类型,执行率从5%到30%不等。私营部门的ERP总体实施率（21.2％）高于公共部门（14.4％）。一些手术的结果是相反的，特别是一些癌症。患者在公共部门的Charlson得分较高。
结论：这项大规模的国家研究提供了法国ERP扩散程度的图片。尽管部门之间存在差异，这种扩散总体上仍然不够。鉴于已证明的ERP的好处，需要更多的教育努力来改善它们在法国的实施。
方法：这是一项基于2019年3月至12月住院时间的回顾性纵向研究。我们研究了ERP协议中最常见的13个活动部分。选择的程序包括消化，妇科,骨科,胸廓,和泌尿外科手术。评估标准是ERP的比率。首先对结果进行总体分析，然后根据机构类型将ERP停留与非ERP停留相匹配，患者年龄和性别,出院月份，和Charlson合并症得分.
结果：我们考虑了420,031次停留，其中78119个被编码为ERP。有62,403个非ERP停留。根据手术类型,执行率从5%到30%不等。私营部门的ERP总体实施率（21.2％）高于公共部门（14.4％）。一些手术的结果是相反的，特别是一些癌症。患者在公共部门的Charlson得分较高。
结论：这项大规模的国家研究提供了法国ERP扩散程度的图片。尽管部门之间存在差异，这种扩散总体上仍然不够。鉴于已证明的ERP的好处，需要更多的教育努力来改善它们在法国的实施。
