AimSame 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.MethodA 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.ResultsThere 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.ConclusionsAmidst 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.

中文翻译：

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当天出院结肠手术：经济上值得吗？

目的结直肠手术当天出院 (SDD) 在手术方案和微创手术加速康复时代显示出越来越大的前景。由于 COVID-19 大流行带来的限制，它变得越来越重要。本研究的目的是比较 SDD 和术后第 1 天 (POD1) 出院，以了解临床结果和财务对成本、费用、收入、边际贡献和再入院等因素的影响。 2年期间内的机构（n= 143）。确定了两个人群：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。结果在住院总费用方面，SDD 存在统计学上的显着差异（p< 0.0001), 平均直接成本 (p< 0.0001) 和平均费用 (p< 0.0016)。SDD 平均住院费用为 8699 美元（全文均以美元计算），而 POD 1 的平均住院费用为 11 652 美元（p< 0.0001），平均 SDD 医院费用为 85 506 美元，而 POD1 为 97 008 美元（p< 0.0016)。SDD 的净收入为 22 319 美元，而 POD1 的净收入为 26 173 美元（p= 0.14）。比较边际贡献（SDD $13 620 vs. POD1 $14 522），差异不具有统计显着性（p= 0.73）。在手术室时间、机器人控制台时间、再入院率或手术并发症方面没有发现统计学上的显着差异。结论在大流行相关的限制中，我们发现与 POD1 相比，SDD 与较低的医院成本和可比的贡献边际相关。此外，该研究无法确定执行 SDD 时手术时间、再入院和手术并发症之间的任何显着差异。