AHN Study: Preoperative Nutrition Program Cuts Surgery Costs and Complications

Friday, November 01, 2024

Press Releases Cancer Institute

Key Takeaways

• Implementing a system-wide preoperative nutrition program projected an 18% decrease in hospitalization days and a 33% decrease in postoperative complications across multiple surgical specialties.
• The program's financial implications include a projected estimated annual savings of $7.8 million for the payer/insurance sector.
• Preoperative nutrition interventions are shown to reduce "outlier days" - hospital days exceeding the expected number - which significantly contributes to overall cost savings.

PITTSBURGH (November 1, 2024) - A system-wide preoperative nutrition program improves patient outcomes and offers the potential for substantial cost savings for health care systems, according to a new study conducted by clinicians at Allegheny Health Network in Pittsburgh, presented at the American College of Surgeons (ACS) Clinical Congress 2024 in San Francisco, California. The study findings highlight the value of using nutrients to support the immune system before surgery to reduce hospital stays and decrease postoperative complications.

The study suggests that patients who "carbo-load" in the hours prior to surgery with over-the-counter immunonutrition "shakes"- filled with omega-3 fatty acids and arginine to support immune health and surgical recovery - can see improved general well-being both before and after surgery. Historically, nutrition programs have been used for cancer patients, but the researchers at AHN propose that there may be benefits in expanding the practice to more surgical patients. This study looked at patients across eight different surgical specialties.

"Our findings show that incorporating preoperative nutrition as a standard part of surgical care can lead to significant reductions in health care utilization and costs," said Edward A. Joseph, MBBS, lead author and cancer clinical outcomes research fellow at AHN. "These results emphasize the importance of routine nutritional support in the preoperative period to enhance patient recovery and reduce financial burdens on health care systems."

Study Overview

Researchers analyzed administrative claims data from 4,078 surgical cases within the Allegheny Health Network health care system, spanning eight surgical specialties. They conducted a systematic review to project the impact of preoperative nutrition on hospitalization and long-term complication rates. The review found an average 18% reduction in hospital stays and a 33% decrease in complications, translating to a cumulative reduction of 2,699 hospital days (HD) and 865 outlier days (HD>30) over the study period, ultimately resulting in an estimated annual savings of $7.8 million.

Key decreases in health care utilization included:

• 865 Outlier Days Reduced: The program notably reduced "outlier days," defined as hospital days exceeding expected duration, which are a significant cost to payers. This reduction alone accounted for $6.1 million in projected savings.
• Long-Term Complication Decrease: By decreasing the rate of long-term complications, the study estimates an additional $1.9 million in savings.

Projected Financial Impact

The study projected the total health care utilization cost for the analyzed procedures to be approximately $130.9 million in potential savings. Implementing the preoperative nutrition program, which costs about $244,680 annually (4,078 patients at $60 per nutrition bundle), resulted in an estimated total savings of $7.8 million annually for the payer/insurance sector. Health care providers benefit from the overall reduction in hospital days and decreased complications, which can translate to better resource utilization and potential cost savings in terms of staffing, bed availability, and other operational costs.

According to the study authors, adopting a system-wide preoperative nutrition program can enhance patient outcomes significantly while providing a substantial financial benefit to payers and providers. "These findings underscore the need for more widespread implementation of preoperative nutritional support, as it offers a clear path to improving care and reducing costs," Dr. Joseph said.

AHN co-authors of the study include Nathan Bloom, MBA, BS; Camille Hamlet, MBA, MHA, BSN, RN-BC; David L. Bartlett, MD, FACS, Chair of the AHN Cancer Institute; Sricharan Chalikonda, MBBS, FACS, Chair of the Surgical Institute at AHN; and Casey J. Allen, MD, FACS, surgical oncologist at AHN.

Authors have no disclosures to report.

Citation: Joseph EA, et al. Projected Financial Implications of a System-Wide Preoperative Nutrition Program, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2024.

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About the American College of Surgeons

The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 90,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the ACS.