Increasing Efficiency of Inpatient Care in the Czech Republic: ERAS Protocol Adherence in Colorectal Surgery

Barbora Hrušková Abstract Standardization of care is necessary to achieve more efficient inpatient care. En- hanced recovery after surgery (ERAS) protocols have proven to accelerate the recov- ery of patients, decrease lengths of stay and reduce complications. However, close adherence to the protocol is necessary to achieve the beneficial outcomes. The pur- pose of this study is to prove that higher adherence to ERAS protocol increases its efficiency by achieving lower expenses and higher productivity due to the decreased patient length of stay. De-identified dataset of patients who underwent colorectal surgery between April 2016 and March 2020 at Motol University Hospital was used for our analysis. Ordinary least squares (OLS) models were created to investigate the effect of adherence to individual items of the protocol as well as the different levels of total adherence on the length of stay. We proved that seven items of ERAS protocol are independent predictors of the length of stay. Moreover, we found an inverse relationship between the ERAS protocol adherence and the length of stay. Finally, after assigning monetary values to our results we could conclude that higher adherence to ERAS protocols provides more efficient inpatient care and contributes to cost savings in the Czech Republic