OBJECTIVEThe purpose of this study was to compare total cost and length of stay (LOS) between spine surgery patients enrolled in an enhanced perioperative care (EPOC) pathway and patients receiving traditional perioperative care (TRDC).METHODSAll spine surgery candidates were screened for inclusion in the EPOC pathway. This cohort was compared to a retrospective cohort of patients who received TRDC and a concurrent group of patients who met inclusion criteria but did not receive the EPOC (no pathway care [NOPC] group). Direct and indirect costs as well as hospital and intensive care LOSs were analyzed between the 3 groups.RESULTSTotal costs after pathway implementation decreased by $19,344 in EPOC patients compared to a historical cohort of patients who received TRDC and $5889 in a concurrent cohort of patients who did not receive EPOC (NOPC group). Hospital and intensive care LOS were significantly lower in EPOC patients compared to TRDC and NOPC patients.CONCLUSIONSThe implementation of a multimodal EPOC pathway decreased LOS and cost in major elective spine surgeries.
Keywords: CPT = Current Procedural Terminology; EPOC = enhanced perioperative care; ERAS; ERAS = enhanced recovery after surgery; HLOS = hospital length of stay; ICD-9 = International Classification of Diseases, Ninth Revision; ILOS = intensive care length of stay; LOS = length of stay; NOPC = no pathway care; TRDC = traditional perioperative care; cost analysis; enhanced recovery after surgery; fast track; length of stay; major spine surgery; perioperative medicine; value.